Atypical hand, foot, and mouth disease in an adult patient: a case report and literature review

Šabović, Eva Klara Merzel; Točkova, Olga; Uršič, Tina; Žgavec, Borut; Dolenc‐Voljč, Mateja

doi:10.15570/actaapa.2019.21

Cited by 6 publications

(10 citation statements)

References 33 publications

(52 reference statements)

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“…Only 11% of the adults exposed to the infection and less than 1% of infected adults develop HFMD [ 9 ]. In recent years, several cases of HFMD in adults were reported worldwide [ 3 4 ]. Adult HFMD cases are often associated with CVA6, and the first case was identified in Finland after a major outbreak of HFMD in 2008 [ 4 ].…”

Section: Discussionmentioning

confidence: 99%

“…Adult HFMD cases are often associated with CVA6, and the first case was identified in Finland after a major outbreak of HFMD in 2008 [ 4 ]. This strain caused outbreaks among both children and adults in Europe and Asia [ 3 4 ].…”

Section: Discussionmentioning

confidence: 99%

“…It often resembles EM or a disseminated herpetic eruption, indicating extensive cutaneous involvement and targetoid macules and papulo-vesicles. Thus, the clinical course of the condition is worse than that of classic cases [ 2 3 10 ]. Moreover, it is characterized by more widespread distribution of skin lesion in areas, including the perioral region, dorsum of the hands and feet, trunk, calves, forearms, and neck, and onychomadesis can occur [ 3 10 ].…”

Section: Discussionmentioning

confidence: 99%

“…Thus, the clinical course of the condition is worse than that of classic cases [ 2 3 10 ]. Moreover, it is characterized by more widespread distribution of skin lesion in areas, including the perioral region, dorsum of the hands and feet, trunk, calves, forearms, and neck, and onychomadesis can occur [ 3 10 ]. The rash in atypical HFMD often presents with ulcerations and scabs, and bullae can be observed [ 10 ].…”

Section: Discussionmentioning

confidence: 99%

“…With the appearance of skin lesions, this condition must be distinguished from other skin diseases, including erythema multiforme (EM), and other viral infections such as chickenpox and measles. Currently, the occurrence of atypical adult HFMD caused by Coxsackievirus A6 (CVA6) is increasing worldwide [ 3 4 5 ]. HFMD caused by CVA6 affects a higher number of adult patients compared with that caused by conventional viruses.…”

Section: Introductionmentioning

confidence: 99%

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Coxsackievirus A6-induced Hand-Foot-and-Mouth Disease Mimicking Stevens-Johnson Syndrome in an Immunocompetent Adult

Jung

et al. 2020

Infect Chemother

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Hand-foot-and-mouth disease, a highly contagious viral infection, occurs more common in children than in adults. However, there was a recent outbreak of Coxsackievirus A6induced infection with an atypical presentation among the adult population. Stevens-Johnson syndrome is a severe mucocutaneous disease characterized by extensive necrosis and detachment of the epidermis, and this condition is commonly caused by medications. Herein, we describe a 30-year-old male patient taking allopurinol for the management of gout. The patient presented with numerous erythematous papules, vesicles, and patches with mucosal eruptions on the whole body, oral mucositis, and fever, and he was finally diagnosed with hand-foot-and-mouth disease.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Coxsackievirus A6-induced Hand-Foot-and-Mouth Disease Mimicking Stevens-Johnson Syndrome in an Immunocompetent Adult

Jung

et al. 2020

Infect Chemother

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Emerging concerns of atypical hand foot and mouth disease caused by recombinant Coxsackievirus A6 variants in Henan, China

Chen,

et al. 2023

Journal of Medical Virology

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An increasing number of studies have reported that atypical hand, foot, and mouth disease (HFMD) is becoming a new concern for children's health. At present, there is no official definition for atypical HFMD, but some studies have defined that it occurs at anatomic sites not listed in the definition of HFMD issued by the World Health Organization. Several pathogens have been reported to cause atypical HFMD, such as Coxsackievirus (CV)A6. As one of the most prevalent enteroviruses in the world, CVA6 seems to affect a wider range of children and causes more severe and prolonged illness than other enteroviruses. The early lesions of atypical HFMD are very similar to the clinical presentations of other diseases, such as eczema, which poses a challenge for clinicians aiming to identify and diagnose HFMD in a timely manner. Here, we report on six atypical HFMD patients caused by recombinant CVA6 variants, and the atypical manifestations include eczema coxsackium, large herpes, rice‐like red papules and herpes, purpuric rash, and onychomadesis, as well as and large red herpes on scalp, perianal, testicles, shoulders and neck, and other atypical eruption sites, hoping to draw the attention of other pediatricians. This study will provide scientific guidance for timely diagnosis of HFMD to prevent serious complications.

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Seasonality of the transmissibility of hand, foot and mouth disease: a modelling study in Xiamen City, China

Huang

Wang²,

Qiu

et al. 2019

Epidemiol. Infect.

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This study attempts to figure out the seasonality of the transmissibility of hand, foot and mouth disease (HFMD). A mathematical model was established to calculate the transmissibility based on the reported data for HFMD in Xiamen City, China from 2014 to 2018. The transmissibility was measured by effective reproduction number (Reff) in order to evaluate the seasonal characteristics of HFMD. A total of 43 659 HFMD cases were reported in Xiamen, for the period 2014 to 2018. The median of annual incidence was 221.87 per 100 000 persons (range: 167.98/100,000–283.34/100 000). The reported data had a great fitting effect with the model (R2 = 0.9212, P < 0.0001), it has been shown that there are two epidemic peaks of HFMD in Xiamen every year. Both incidence and effective reproduction number had seasonal characteristics. The peak of incidence, 1–2 months later than the effective reproduction number, occurred in Summer and Autumn, that is, June and October each year. Both the incidence and transmissibility of HFMD have obvious seasonal characteristics, and two annual epidemic peaks as well. The peak of incidence is 1–2 months later than Reff.

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Atypical hand, foot, and mouth disease in an adult patient: a case report and literature review

Cited by 6 publications

References 33 publications

Coxsackievirus A6-induced Hand-Foot-and-Mouth Disease Mimicking Stevens-Johnson Syndrome in an Immunocompetent Adult

Coxsackievirus A6-induced Hand-Foot-and-Mouth Disease Mimicking Stevens-Johnson Syndrome in an Immunocompetent Adult

Emerging concerns of atypical hand foot and mouth disease caused by recombinant Coxsackievirus A6 variants in Henan, China

Seasonality of the transmissibility of hand, foot and mouth disease: a modelling study in Xiamen City, China

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