Four Cases of Onychomadesis after Hand-Foot-Mouth Disease

Kim, Eun Jee; Park, Hyun Sun; Yoon, Hyun-Sun; Cho, Soyun

doi:10.5021/ad.2014.26.6.777

Cited by 18 publications

(16 citation statements)

References 4 publications

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“…It remains unclear whether onychomadesis is specifically linked to CA6 infection or is common to several HEVs. The mechanism of onychomadesis is also unknown [66]. As onychomadesis usually occurs in 1-2 months after HFMD onset, the quality of the follow-up studies are likely the reason for the incongruous results.…”

Section: Onychomadesismentioning

confidence: 98%

Coxsackievirus A6: a new emerging pathogen causing hand, foot and mouth disease outbreaks worldwide

Bian

Wang

Yao

et al. 2015

Expert Review of Anti-infective Therapy

178

141

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Enterovirus 71 (EV71) and coxsackievirus A16 (CA16) are the predominant pathogens causing outbreaks of hand, foot and mouth disease (HFMD) worldwide. Other human enterovirus A (HEV-A) serotypes tend to cause only sporadic HFMD cases. However, since a HFMD caused by coxsackievirus A6 broke out in Finland in 2008, CA6 has been identified as the responsible pathogen for a series of HFMD outbreaks in Europe, North America and Asia. Because of the severity of the clinical manifestations and the underestimated public health burden, the epidemic of CA6-associated HFMD presents a new challenge to the control of HFMD. This article reviewed the epidemic characteristics, molecular epidemiology, clinical features and laboratory diagnosis of CA6 infection. The genetic evolution of CA6 strains associated with HFMD was also analyzed. It indicated that the development of a multivalent vaccine combining EV71, CA16 and CA6 is an urgent necessity to control HFMD.

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Section: Onychomadesismentioning

confidence: 98%

Coxsackievirus A6: a new emerging pathogen causing hand, foot and mouth disease outbreaks worldwide

Bian

Wang

Yao

et al. 2015

Expert Review of Anti-infective Therapy

178

141

View full text Add to dashboard Cite

show abstract

“…While hand, foot, and mouth disease is seen with mostly frequently with coxsackie virus A16 as well as coxsackie virus A6, A7, A9, A10, B1, B2, B3, B5; it is also seen with echoviruses E3, E4, E9 and various enteroviruses such as enterovirus 71, onychomadesis cases followed by HFMD were reported to be secondary to coxsackie virus A6. Apart from that, it was also reported that onychomadesis was secondary following the cases of coxsackie virus A5, A6, A10, A16, B1, B3, echovirus 3, 4, 9 and enterovirus 71 (5,6). Since our patients had the typical HFMD clinical picture, no virus typology was implemented.…”

Section: Discussionmentioning

confidence: 81%

“…Onychomadesis is defined as proximal nail plate separation with the temporary arrest in the activity of the nail matrix (5). As onychomadesis can be secondary to infections, autoimmune diseases, drugs and traumas, it can be hereditary as well (6).…”

Section: Introductionmentioning

confidence: 99%

Nail Matrix Arrest during the Course of Hand, Foot, and Mouth Disease: Evaluation of Onychomadesis Cases

Büyükçam¹,

Boyraz²,

Hanalioğlu³

et al. 2015

Çocuk Enf Derg

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Objective: Hand foot, and mouth disease (HFMD) is an infectious disease that is particularly common in children. HFMD is clinically characterized by erosive stomatitis that occurs with vesicular and maculopapular rash. This rash is frequently observed in the hands and feet and sometimes in the gluteal and inguinal regions. It is known that various enteroviruses, including coxsackievirus, echovirus, and enterovirus 71, may be causative agents. HFMD is usually a self-limited and benign condition; however, fatal cardiopulmonary and neurological complications may be occasionally observed cases with enterovirus 71 infection. Onychomadesis is defined as proximal nail plate separation with a temporary arrest in the activity of the nail matrix. In this article, we present four onychomadesis cases that occurred as a rare complication of HFMD. Material and Methods: In the present study, we included patients who presented with onychomadesis after HFMD diagnosis between January 2013 and December 2014 at the Hacettepe University Faculty of Medicine, Pediatric Infectious Diseases Outpatient Clinic. Results: Four onychomadesis cases diagnosed with HFMD were included in this study. All patients were males, and their ages were 11 years, 21 months, 7 years, and 27 months. The underlying disease in one patient was ALL in remission. None of the patients had a history of skin disease. The periods from HFMD diagnosis to nail changes were 3 weeks and 2 months for the first two patients and 4 weeks for the other two patients. Onychomadesis was improved without any treatment during the follow-up. Conclusion: Onychomadesis after HFMD is a benign clinical disorder. In the differential diagnosis of pediatric cases of onychomadesis, the patients should be queried about a history of HFMD.

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“…It is attributed to the damage of the nail matrix which can be caused directly by viral replication or indirectly by virus specific immunocomplexes. 10,11 The difference in the rate of occurrence of onychomadesis in various studies can be attributed to the viral etiology of HFMD where nail changes are more pronounced in infection with cosackievirus A16 when compared to enterovirus 71. 12,13 Unfortunately microbiological evidence for causative organism could not established in our study due to limited resources.…”

Section: Discussionmentioning

confidence: 99%

Onychomadesis associated with hand, foot, and mouth disease: a prospective observational study from North Chennai

2020

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Background: Hand, foot, and mouth disease (HFMD) is a common febrile illness caused by coxsackievirus A16 and human enterovirus 71 characterized by vesicular eruptions on hands and feet and enanthem on oral mucosa. Resolves usually without complications but onychomadesis can occur as a late sequlae sometimes. Methods: Children with clinical diagnosis of HFMD between April to June 2018 were included in the study. Age, sex, duration of illness, cutaneous features and nail changes were noted at initial visit and during every week for next 6 weeks. Results: 58 children were recruited in the study with boys to girl's ratio 1.2:1. The average age was 5.3 years. The vesicular lesions predominantly involved palms and soles (88.3%). 65.5% had history of fever and pruritis was the commonest cutaneous symptom. 27 children (48.21%) developed onychomadesis during follow up with average time interval of 3.2 weeks between the clinical diagnosis and nail shedding. Reassurance about spontaneous resolution of the condition given to the parents. Conclusions: Our study strengthened the association between the HFMD and occurrence of onychomadesis. Physician's awareness about this benign condition is needed to avoid parental anxiety, unnecessary investigations and treatment for the children.

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Four Cases of Onychomadesis after Hand-Foot-Mouth Disease

Cited by 18 publications

References 4 publications

Coxsackievirus A6: a new emerging pathogen causing hand, foot and mouth disease outbreaks worldwide

Coxsackievirus A6: a new emerging pathogen causing hand, foot and mouth disease outbreaks worldwide

Nail Matrix Arrest during the Course of Hand, Foot, and Mouth Disease: Evaluation of Onychomadesis Cases

Onychomadesis associated with hand, foot, and mouth disease: a prospective observational study from North Chennai

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