Atypical hand, foot, and mouth disease: a vesiculobullous eruption caused by Coxsackie virus A6

Feder, Henry M.; Bennett, Nicholas; Modlin, John F.

doi:10.1016/s1473-3099(13)70264-0

Cited by 135 publications

(126 citation statements)

References 28 publications

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“…The presentation of Cocksackie A6 HFMD described in our four patients is atypical given the adult age predilection and a more generalized distribution involving the face and forehead as well as the dorsum of the hands and feet. Other unusual features that have been reported include onychomadesis, bullae formation, high fever, and increased rates of hospitalization [1]. While orchiitis has been demonstrated with other enterovirus infections (particularly coxsackie virus A9), we believe that patient two represents the first case reported of orchitis with Coxsackie virus A6 infection.…”

Section: Discussionmentioning

confidence: 65%

“…Symptoms generally persist less than a week and are treated with supportive care. The most common causes are Coxsackie virus A16 and enterovirus 71 [1,3]. doi: 10.15761/GOD.1000106…”

Section: Discussionmentioning

confidence: 99%

“…Cocksackie virus A6 causes a more severe form of HFMD in Europe, Asia, and the United States [1]. In children, this severe form has a spectrum of manifestations including widespread distribution, petechial eruption, and "eczema coxsackium", which is the predilection of the HFMD vesicles for areas of eczema.…”

Section: Discussionmentioning

confidence: 99%

“…It usually manifests as a febrile illness with papules and vesicles on the oral mucosa, buttocks, hands and feet. The primary cause is an enterovirus, most commonly Coxsackie virus A16 or enterovirus 71 [1]. We present a case series of patients with an atypical presentation of HFMD caused by Coxsackie virus A6 to demonstrate the cutaneous manifestations, age distribution, associated clinical features, and laboratory diagnosis.…”

Section: Introductionmentioning

confidence: 99%

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2014

Glob Dermatol

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Section: Discussionmentioning

confidence: 65%

“…Symptoms generally persist less than a week and are treated with supportive care. The most common causes are Coxsackie virus A16 and enterovirus 71 [1,3]. doi: 10.15761/GOD.1000106…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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2014

Glob Dermatol

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“…Esta distribución extensa de las lesiones se asocia a un serotipo CA6 y a factores de riesgo como edad menor de 3 años y dermatitis atópica (2,13) . Dichas presentaciones se conocen como las formas atípicas de EMPB, y difieren en que afectan el área perioral, extremidades y torso, adicional a las manifestaciones clásicas del EMPB, con un exantema eritematoso papular que ocupan más del 10% de superficie corporal total (SCT), y menor compromiso oral (4,14) .…”

Section: Discussionunclassified

Enfermedad de mano, pie y boca en un hospital del Callao, 2016

Rodríguez-Zúñiga

Vértiz-Gárate

Cortez-Franco

et al. 2017

Rev Peru Med Exp Salud Publica

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RESUMENLa enfermedad de mano, pie y boca (EMPB) es una enfermedad exantemática viral, causada principalmente por Coxsackie A16, con una sintomatología típica consistente en fiebre; exantema pápulo-vesicular en manos, pies y genitales; y un enantema ulceroso en boca. En el verano del 2016 se presentó una diversidad de casos en un hospital del Callao en niños y adultos, con una sintomatología compatible con EMPB; el diagnóstico fue clínico, se aplicó terapia de soporte con resolución final de síntomas. En la última década se han presentado reportes en algunos países con una afectación atípica causada por el Coxsackie A6, produciendo lesiones más extensas y en adultos. Sin embargo, el diagnóstico sigue siendo clínico, solo necesitando confirmación virológica en casos atípicos o cuando el diagnóstico no es claro. La importancia de este reporte radica en describir los casos del Callao ocurridos en el verano del 2016, para servir de apoyo a los profesionales de la salud en el diagnóstico y manejo de pacientes con similar sintomatología. HAND, FOOT, AND MOUTH DISEASE IN A HOSPITAL IN CALLAO IN 2016 ABSTRACTHand, foot, and mouth disease (HFMD) is an exanthematous viral disease caused mainly by Coxsackie A16 with a typical symptomatology of fever, papulovesicular rash on the hands, feet, and genitals, and an ulcerous enanthem in the mouth. In the summer of 2016, a variety of cases presented at a hospital in Callao in children and adults with a symptomatology consistent with HFMD. A clinical diagnosis was made, and support therapy was applied, resulting in the resolution of symptoms. In the last decade, reports have emerged in some countries of an atypical involvement caused by Coxsackie A6, producing lesions that are more widely distributed in adults. However, the diagnosis remains clinical, only requiring virological confirmation in atypical cases or when the diagnosis is unclear. The importance of this report stems from its description of the cases in Callao that occurred in the summer of 2016 and serve as an example for health professionals in the diagnosis and management of patients with similar symptomatology.

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Diffuse Vesicular Eruption

2017

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A man in his 70s with a history of chronic lymphocytic leukemia (CLL) and prescribed cyclosporine, 100 mg twice daily, for pure red cell aplasia was admitted for spreading painful blisters on the hands and feet. He had initially developed rhinorrhea, cough, and lowgrade fever 2 weeks prior. The patient was treated with azithromycin and subsequently developed few small, pruritic blisters on the hands and feet. He went to an urgent care facility and was diagnosed as having bronchitis and prescribed doxycycline and diphenhydramine. Over the next several days, he developed worsening fever, chills, and blisters and bullae on the arms, legs, and face. He was admitted to the hospital, and the dermatology service was consulted. Physical examination revealed numerous pink to violaceous macules, papules, and patches on the palms, dorsal hands, forearms, elbows, feet, and distal lower extremities (Figure , A and B). Fewer, scattered macules were on the face, neck, trunk, upper legs, upper arms, and scrotum. Dusky bullae were seen on the bilateral dorsal aspect of the hands, fingers, toes, and heels. In the oral cavity, there was 1 violaceous macule on the right buccal mucosa and a few linear, horizontal, white lines on the left buccal mucosa. Laboratory findings revealed a white blood cell count of 25 600/μL (reference range, 3700-10 500/μL) and a platelet count of 12 400/μL (reference range, 15 000-40 000/μL). Results from a Tzanck smear from the initial lesion on the right dorsal aspects of the third finger were negative for multinucleated giant cells. A punch biopsy was performed on the anterior side of the thigh (Figure, C and D).

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Atypical hand, foot, and mouth disease: a vesiculobullous eruption caused by Coxsackie virus A6

Cited by 135 publications

References 28 publications

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Enfermedad de mano, pie y boca en un hospital del Callao, 2016

Diffuse Vesicular Eruption

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