Joint diagnosis of pediatric and dermatology clinics: Prospective observation of thirtynine patients with hand, foot and mouth disease

Abstract

Background and Design: Hand, foot and mouth disease (HFMD) is a childhood enteroviral eruptive disease presenting with fever and cutaneous and mucosal lesions. It is benign and generally resolves spontaneously, but may sometimes result in systemic involvement. The purpose of this study was to share our clinical experience concerning patients who were followed with the diagnosis of HFMD established by the pediatric and dermatology clinics. Materials and Methods: We prospectively evaluated patients who attended our hospital with the complaints of fever and eruptions and received the diagnosis of HFMD based on the clinical findings between December 2014 and November 2015. Age, sex, month of presentation, presentation symptoms and duration of symptoms were investigated. Systemic and dermatological examination findings, laboratory results and tests such as echocardiography were reviewed. Results: Thirty-nine patients were included; 19 (48.8%) were girl and 20 (51.2%) were boy. The mean age of the patients was 29.8±27.9 (6-155) months. Six (15.3%) patients were in the 0-12 month age group, while only 3 (7.8%) were older than 60 months. Presentations were most common in September, June and October. The most common presentation symptoms were eruptions on the hands and feet (100%), fever (82.1%) and oral aphthae (79.5%). The lesions were most commonly observed on the hands (94.9%, n=37) and feet (87.2%, n=34) and in the mouth (79.5%, n=31). Cardiac involvement was determined in 3 (7.7%) patients. Nail changes were observed during monitoring in 10 (25.6%) patients. AbstractAmaç: El-ayak-ağız hastalığı (EAAH); ateş, deri ve mukoza lezyonları ile seyreden, çocukluk çağının enteroviral döküntülü bir hastalığıdır. İyi seyirli ve kendiliğinden düzelme eğiliminde olmakla birlikte, nadiren sistemik tutuluma yol açabilir. Bu çalışmanın amacı, pediatri ve dermatoloji klinikleri tarafından EAAH tanısıyla takip edilen hastalara ait klinik deneyimlerimizi paylaşmaktır. Gereç ve Yöntem: Hastanemize Aralık 2014-Kasım 2015 tarihleri arasında ateş ve döküntü şikayeti ile başvuran hastalardan, klinik bulgulara dayanılarak EAAH tanısı koyulan hastalar prospektif olarak değerlendirildi. Hastaların yaşı, cinsiyeti, başvuru ayı, başvuru şikayeti ve süresi sorgulandı. Sistemik ve dermatolojik muayene bulguları, laboratuvar sonuçları, ekokardiyografi gibi ek inceleme tetkikleri gözden geçirildi. Bulgular: Çalışmaya toplam 39 hasta dahil edildi. Hastaların 19'u (%48,8) kız, 20'si (%51,2) erkek idi. Hastaların ortalama yaşı 29,8±27,9 (6-155) ay olarak hesaplandı. Yaş aralığına göre hastaların 6'sı (%15,3) 0-12 ay arasında iken, sadece 3'ü (%7,8) 60 aydan büyüktü. Başvurular en sık Eylül, Haziran ve Ekim aylarında görüldü. En sık başvuru şikayeti; el ve ayaklarda döküntü (%100), ateş (%82,1) ve oral aft (%79,5) idi. Lezyonlar, en sık el (%94,9, n=37), ayak (%87,2, n=34) ve ağız içinde (%79,5, n=31) görüldü. Üç hastada (%7,7) kardiyak tutulum saptandı. Takiplerde 10 hastada (%25,6) tırnak değişikliği gelişti. Sonuç: Çalışmamız sonucunda ülkemizde E...

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

“…In our study , there was slight male predominance (boys: girls = 1.2 : 1) which was in accordance with Bucak et al and Ghosh et al 5,6 The predominant age group affected was 5.3 years in our study which was almost similar to Bucak et al (4.9 years) and Ghosh et al (5.1 years). 5,6 But, Li et al and Jeelani et al reported in younger age group of 3.5 years and 2.2 years respectively. 7,8 Nevertheless, our study is in accordance with literatures that HFMD is common around children of 5 years.…”

“…9 In our study, the vesicular lesions predominantly involved palms and soles in accordance with previous studies. 5,6 The second commonest site involved was oral cavity in our study similar to Bucak et al while Ghosh et al reported it as gluteal region. Atypical lesions of HFMD like lesions involving only one body region, lesions in trunk without palms, soles and oral involvement, involvement of genitalia has also been reported.…”

“…6 But, the results of our study are within the range of 3-10 weeks reported in other studies. 3,5 Two children had concurrent lesions of HFMD and Onychomadesis at the initial visit itself. This may be due to delay in the clearance of HFMD lesions in these children which normally occurs within a week.…”

Evaluation of Laboratory and Demographic Data of Children Presenting with Hand, Foot and Mouth Disease

“…In this study, it was determined that 40.4% of the children in the experimental group had fever, while none of the children in the control group had fever. In four different studies conducted in our country, the reported incidence of fever in children with hand-foot-and-mouth disease varied between 61.40% and 82.10% (6,(9)(10)(11). The incidence of fever was lower in this study.…”

“…In three different studies conducted in our country, the percentage of cases in children under the age of five was reported as 52.30%, 79% and 87.40%, respectively (6,9,10). In their study, Bucak et al reported the percentage of patients under the age of five as 92.30% and the percentage of patients under the age of one as 15.30% (11). It is stated that the younger the child, the greater the severity of the disease (7,12).…”