Onychomadesis secondary to hand-foot-and-mouth disease: report of two cases

Ocanha‐Xavier, Juliana Polizel; Xavier, J. C.

doi:10.1016/j.abd.2019.06.011

Cited by 2 publications

(4 citation statements)

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“…Nail changes commonly manifest 30 to 90 days after an acute viral infection episode. Coxsackievirus A16 has been confirmed to be a culprit in patients with onychomadesis secondary to HFMD; enteroviruses have also been implicated but to a lesser extent [ 7 - 8 ]. Nail changes secondary to HFMD are a peculiar complication.…”

Section: Discussionmentioning

confidence: 99%

“…Those late complications could affect the nail matrix leading to onychomadesis and Beau’s line. Onychomadesis is a proximal separation of the nail bed while Beau’s line is a white transverse line alluding to the halted growth of the nail plate [ 7 - 8 ]. Onychomadesis could be attributed to many factors like trauma, fever, chemotherapy-induced, and medication ingestion.…”

Section: Discussionmentioning

confidence: 99%

“…Onychomadesis could be attributed to many factors like trauma, fever, chemotherapy-induced, and medication ingestion. The presence of onychomadesis indicates a severe nail disorder more than Beau’s line [ 7 - 8 ]. Furthermore, when nail matrix proliferation is interrupted, the nail de-attaches from the nail bed.…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, when nail matrix proliferation is interrupted, the nail de-attaches from the nail bed. When a new nail grows without connection to the older nail, this leads to proximal nail separation [ 8 ]. Nail changes following HFMD infection are a rare phenomenon; however, they are emerging lately, and onychomadesis is more commonly reported in HFMD patients than in Beau’s line [ 6 - 10 ].…”

Section: Discussionmentioning

confidence: 99%

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Onychomadesis and Beau's Line Following Hand-Foot-and-Mouth Disease in a Seven-Year-Old Male

Ali¹,

Mazraani²,

Alghamdi³

et al. 2022

Cureus

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Hand-foot-and-mouth disease (HFMD) is a viral infection frequently encountered in the pediatric age group. Common culprits in such manifestations are coxsackievirus A16 and human enterovirus 71. The patient presents febrile with erythematous papulovesicular exanthems in the mouth, palms, and soles. HFMD is self-limiting in nature with a rare-complication rate. Onychomadesis is proximal nail separation while Beau’s lines are whitish transverse lines and considered a rare complication of HFMD. Both allude to halted nail-matrix proliferation, and the pathophysiology behind such manifestations is still not yet understood. It is hypothesized that the virus elicits an inflammatory process, inhibiting nail-matrix proliferation or immune-complexes depositing on nails creating an embolism. Onychomadesis and Beau’s lines appear after four to eight weeks of HFMD disease resolution and persist for approximately 35 days. There are no serious sequelae of those manifestations, as the nail basement is still intact. We present a case of a seven-year-old Saudi male presenting with nail changes, mainly onychomadesis and Beau’s lines, after 35 days of HFMD disease resolution. All causes of nail changes have been ruled out and diagnosis of onychomycosis and Beau’s lines secondary to HFDM has been established.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Onychomadesis and Beau's Line Following Hand-Foot-and-Mouth Disease in a Seven-Year-Old Male

Ali¹,

Mazraani²,

Alghamdi³

et al. 2022

Cureus

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Hand, Foot, and Mouth Disease: A Narrative Review

Leung

Lam

Barankin³

et al. 2022

RAIAD

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Background: Hand, foot, and mouth disease is a common viral disease in childhood. Because the disease has the potential to reach epidemic levels and the mortality is high in some countries, early recognition of this disease is of paramount importance. Objective: This purpose of this article is to familiarize pediatricians with the clinical manifestations and management of hand, foot, and mouth disease. Methods: A search was conducted in February 2022 in PubMed Clinical Queries using the key term " hand, foot, and mouth disease". The search strategy included all clinical trials, observational studies, and reviews published within the past 10 years. Only papers published in the English literature were included in this review. Results: Hand, foot, and mouth disease is characterized by a painful oral enanthem and asymptomatic exanthem on the palms and soles. Children younger than 5 years are most commonly affected. Hand, foot, and mouth disease caused by enterovirus A71 is more severe and has a higher rate of complications than that attributed to other viruses such as coxsackievirus A16. Circulatory failure secondary to myocardial impairment and neurogenic pulmonary edema secondary to brainstem damage are the main causes of death. Fortunately, the disease is usually benign and resolves in 7 to10 days without sequelae. Given the self-limited nature of most cases, treatment is mainly symptomatic and supportive. Intravenous immunoglobulin should be considered for the treatment of severe/complicated hand, foot, and mouth disease and has been recommended by several national and international guideline committees. Currently, there are no specific antiviral agents approved for the treatment of the disease. Drugs such as ribavirin, suramin, mulberroside C, aminothiazole analogs, and sertraline have emerged as potential candidates for treatment of hand, foot, and mouth disease. Vaccination of susceptible individuals in high-risk areas and good personal hygiene are important preventative measures to combat the disease. Conclusion: Familiarity of the disease including its atypical manifestations is crucial so that a correct diagnosis can be made, and appropriate treatment initiated. A timely diagnosis can help avoid contact with the affected individual and decrease the risk of an outbreak.

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Onychomadesis secondary to hand-foot-and-mouth disease: report of two cases

Cited by 2 publications

References 4 publications

Onychomadesis and Beau's Line Following Hand-Foot-and-Mouth Disease in a Seven-Year-Old Male

Onychomadesis and Beau's Line Following Hand-Foot-and-Mouth Disease in a Seven-Year-Old Male

Hand, Foot, and Mouth Disease: A Narrative Review

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