Atypical Forms of Hand, Foot, and Mouth Disease: A Prospective Study of 47 Italian Children

Neri, Iria; Dondi, Arianna; Wollenberg, Andreas; Ricci, Lorenza; Ricci, Giampaolo; Piccirilli, Giulia; Lazzarotto, Tiziana; Patrizi, Annalisa

doi:10.1111/pde.12871

Cited by 33 publications

(29 citation statements)

References 36 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…7 The cutaneous findings of our adult patients were similar to the atypical diffuse vesiculobullous forms of childhood, which is one of the four main patterns of atypical HFMD described in children. [7][8][9] In our cluster, the extent of cutaneous lesions was mild in five of 10 patients, moderate in four of 10 patients and severe in one of 10 patients. A severe extension seems more common in children: at least 50% could present an involvement >25% BSA.…”

Section: Editormentioning

confidence: 53%

Hand, foot and mouth disease: an overview of clinical features in adult patients

Neri

Chessa

Virdi

et al. 2016

Acad Dermatol Venereol

View full text Add to dashboard Cite

Section: Editormentioning

confidence: 53%

Hand, foot and mouth disease: an overview of clinical features in adult patients

Neri

Chessa

Virdi

et al. 2016

Acad Dermatol Venereol

View full text Add to dashboard Cite

“…Eczema coxsackium ( EC ) is a disseminated form of Coxsackie virus infection mostly occurring in children with active AE lesions. The Coxsackie virus A6 strain leads to atypical disease manifestations, which are classified as diffuse form (lesions extended to the trunk), acral form (lesions with a mainly acral distribution) or eczema coxsackium (disseminated lesions on pre‐existing eczematous areas) . Symptomatic treatment includes use of topical steroids and wet wrap therapy …”

Section: Antimicrobial Therapymentioning

confidence: 99%

“…The Coxsackie virus A6 strain leads to atypical disease manifestations, which are classified as diffuse form (lesions extended to the trunk), acral form (lesions with a mainly acral distribution) or eczema coxsackium (disseminated lesions on pre-existing eczematous areas). 33 Symptomatic treatment includes use of topical steroids and wet wrap therapy. 34,35 Regional vaccination programmes should be followed by all AE patients as recommended.…”

Section: Antibacterialmentioning

confidence: 99%

Consensus‐based European guidelines for treatment of atopic eczema (atopic dermatitis) in adults and children: part II

Wollenberg

Barbarot

Bieber

et al. 2018

Acad Dermatol Venereol

580

717

View full text Add to dashboard Cite

This guideline was developed as a joint interdisciplinary European project, including physicians from all relevant disciplines as well as patients. It is a consensus-based guideline, taking available evidence from other guidelines, systematic reviews and published studies into account. This second part of the guideline covers antimicrobial therapy, systemic treatment, allergen-specific immunotherapy, complementary medicine, psychosomatic counselling and educational interventions, whereas the first part covers methods, patient perspective, general measures and avoidance strategies, basic emollient treatment and bathing, dietary intervention, topical anti-inflammatory therapy, phototherapy and antipruritic therapy. Management of AE must consider the individual clinical variability of the disease. Systemic immunosuppressive treatment with cyclosporine, methotrexate, azathioprine and mycophenolic acid is established option for severe refractory cases, and widely available. Biologicals targeting the T helper 2 pathway such as dupilumab may be a safe and effective, disease-modifying alternative

show abstract

“…France, Spain, and Australia); information on NPEV circulation in Italy derived exclusively from occasional studies in particular population, especially in children affected by severe pathological conditions. [37][38][39][40][41][42] In conclusion, AFPS proved to be successful especially after the PHEIC declaration and ES revealed a wide NPEVs circulation, mainly supported by echovirus type 11, 6 and 3.…”

Section: Discussionmentioning

confidence: 99%

Surveillance of poliomyelitis in Northern Italy: Results of acute flaccid paralysis surveillance and environmental surveillance, 2012–2015

Pellegrinelli

Bubba

Prímache

et al. 2016

Human Vaccines & Immunotherapeutics

View full text Add to dashboard Cite

Although in the last years poliovirus (PV) transmission has been reported at the lowest levels ever recorded, the spread of virus from endemic countries endures; the high levels of immigration flows across the Mediterranean Sea jeopardize Italy for PV reintroduction. The World Health Organization (WHO) strategic plan for global poliomyelitis (polio) eradication indicates the nationwide surveillance of Acute Flaccid Paralysis (AFP) as the gold standard for detecting cases of polio. In addition, the Environmental Surveillance (ES), seeking the presence of PV and Non-Polio Enterovirus (NPEV) in sewage, is recognized as a powerful tool to confirm PV circulation in absence of AFP cases, especially in polio-free countries. Here we report the results of AFP surveillance (AFPS) and ES in Lombardy (Northern Italy) from 2012 to 2015.Forty-eight AFP cases were identified during the study period. No AFP case was caused by PV infection. NPEVs were identified in 6.3% (3/48) of AFP cases. The annual AFP incidence rate was 0.87/100 0 000 children <15 y in 2012, 1.42/100 0 000 in 2013, 1.02/100 0 000 in 2014, and 0.47/100 0 000 in 2015; according to WHO indicators, the sensitivity of AFPS was adequate in 2013 and 2014. Completeness of case investigation raised progressively during the study period to achieve the WHO standards in 2014 (92.3%) and 2015 (100%). Completeness of follow-up increased from 72.7% in 2012 to 100% in 2014.In the framework of the ES conducted in Milan, 268 wastewater samples were collected from 2012 to 2015 and no PVs were isolated. In contrast, NPEVs were detected in 65.3% (175/268) of samples. All NPEVs characterized belonged to enterovirus species B: echovirus type 11, 6 and 3 were the most frequently detected viruses, representing 29.1% (41/141), 20.6% (29/141) and 9.2% (13/141) of genotyped NPEVs, respectively.Keeping strong and encouraging both AFPS and ES is crucial to ensure that PV will not return unnoticed in Italy -as well as in other polio-free countries -and, as a final point, to achieve the global polio eradication goal.

show abstract

Atypical Forms of Hand, Foot, and Mouth Disease: A Prospective Study of 47 Italian Children

Abstract: Our prospective study allowed the identification of three HFMD phenotypes differing from the classical form. Clinical care of these patients should include symptomatic treatment of extracutaneous features and, if necessary, hospitalization for complications.

Cited by 33 publications

References 36 publications

Hand, foot and mouth disease: an overview of clinical features in adult patients

Hand, foot and mouth disease: an overview of clinical features in adult patients

Consensus‐based European guidelines for treatment of atopic eczema (atopic dermatitis) in adults and children: part II

Surveillance of poliomyelitis in Northern Italy: Results of acute flaccid paralysis surveillance and environmental surveillance, 2012–2015

Contact Info

Product

Resources

About