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Definition..
Hand-foot-and-mouth disease is a mild,
contagious viral infection common in young
children. Characterized by sores in the mouth
and a rash on the hands and feet, hand-foot-
and-mouth disease is most commonly caused
by a coxsackievirus.
There's no specific treatment for hand-foot-
and-mouth disease. You can reduce your risk
of infection from hand-foot-and-mouth disease
by practicing good hygiene, such as washing
your hands often and thoroughly.
Clinical S/Sx
History
The usual incubation period of hand-foot-and-mouth
(HFM) disease is 4-6 days.
The prodrome is associated with the following:
Low-grade fever
Malaise
Anorexia
Abdominal pain
Sore mouth
The prodrome precedes the development of oral
lesions, followed shortly by skin lesions, primarily on
the hands and feet and occasionally on the buttocks.
Physical
Hand-foot-and-mouth disease is the most
common cause of mouth sores in pediatric
patients.
Yellow ulcers surrounded by red halos
characterize the oral lesions.
These primarily occur on the labial and buccal
mucosal surfaces but may be observed on the
tongue, palate, uvula, anterior tonsillar pillars, or
gums. Unlike herpetic gingivostomatitis, perioral
lesions are uncommon. Coxsackie A virus also
causes herpangina, mostly described as palatal and
posterior oropharyngeal lesions without any
associated exanthem.
The oral ulcers are painful. Children younger than 5
years are predominately more symptomatic than older
patients.
The exanthem typically involves the dorsal
surfaces but frequently may include the palmar,
plantar, and interdigital surfaces of the hands
and feet.
These lesions may be asymptomatic or pruritic.
They usually begin as erythematous macules that
rapidly progress to thick-walled grey vesicles with an
erythematous base.
In young infants, these lesions may also be observed
on the trunk, thighs, and buttocks.
The rash is usually self-limited, lasting approximately
3-6 days.
Case reports have documented subacute, chronic,
and recurring skin lesions.
Causes