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From other websitesContent disclaimerContent on this website is provided for information purposes only. Information about a therapy, service, product or treatment does not in any way endorse or support such therapy, service, product or treatment and is not intended to replace advice from your doctor or other registered health professional. The information and materials contained on this website are not intended to constitute a comprehensive guide concerning all aspects of the therapy, product or treatment described on the website. All users are urged to always seek advice from a registered health care professional for diagnosis and answers to their medical questions and to ascertain whether the particular therapy, service, product or treatment described on the website is suitable in their circumstances. The State of Victoria and the Department of Health shall not bear any liability for reliance by any user on the materials contained on this website. AUTHORS: AFFILIATIONS: CITATION: Received June 25, 2020. Accepted October 19, 2020. Published online December 9, 2020. DISCLOSURES: CORRESPONDENCE: A 7-year-old boy with a history of eczema presented with painful peeling of his fingernails of several days’ duration. He denied any trauma or other inciting injury to his fingernails. His mother had a history of a nail fungus that reportedly had been difficult to treat. On examination, the patient was noted to have peeling of several fingernails from the proximal nail fold spreading distally (Figure). He had no current illness, and his vital signs were within normal limits. There was mild tenderness associated with manipulation of the affected nails. There was no associated nail discoloration, and his digits and palms were unaffected. His toenails were examined and had no abnormalities.  Of note, he had presented to the emergency department 1 month prior with an acute viral illness that had been associated with a rash and vesicles on the hands, feet, and mouth. A diagnosis of hand-foot-and-mouth disease (HFMD) was made, and he had been discharged with supportive care. It was presumed that the cause of the nail peeling, known as onychomadesis, was a late symptom of his previous coxsackievirus infection. Discussion. Coxsackievirus infection—the cause of HFMD—can occur in persons of any age but most commonly occurs in those younger than 5 years of age.1 Coxsackievirus types A and B are part of the nonpolio enterovirus family, of which more than 100 types can infect humans. HFMD is most commonly caused by coxsackievirus A16, but coxsackievirus A6 has been implicated in numerous outbreaks of severe and atypical HFMD.2 This variant tends to be associated with more widespread vesicles, and they often involve the less commonly associated perioral area, extremities, and trunk, but also the palms, soles, and buttocks. About half of all patients infected with coxsackievirus A6 will develop oral lesions, and acral desquamation and onychomadesis are more common compared with infection with other coxsackievirus serotypes. These patients are often febrile but do not have neurological symptoms or other complications.2 Onychomadesis refers to the separation of the nail plate at the proximal nail fold secondary to a severe insult that causes complete cessation of nail matrix activity. The nail matrix is the portion of the nail unit that is responsible for formation of the nail plate. Onychomadesis typically occurs several weeks after infection, often within 3 to 6 weeks. It can be caused by trauma, scarlet fever, Kawasaki disease, or (as in our patient’s case) HFMD.2 Other less typical pediatric causes include chemotherapy, neurological disorders, peritoneal dialysis, cutaneous T-cell lymphoma, pemphigus vulgaris, drug allergy, and keratosis punctata palmaris et plantaris. Immobilization from casting for fractures can also be a contributing factor for the development of onychomadesis. Medications such as antineoplastic agents, azithromycin, and retinoids have also been implicated.3 No intervention or follow-up is required, since the deformity will grow out along with the nail plate. This process can take as long as 6 to 18 months, given that nails grow on average 2 to 3 mm per month.4 REFERENCES:
Can hand foot and mouth have long term effects?While hand, foot and mouth disease is uncomfortable, it rarely causes long-term problems. Most children and adults recover in less than two weeks with minimal treatment. It's possible to have hand, foot and mouth disease multiple times.
How long does hand foot and mouth stay in your system?You are generally most contagious during the first week of illness. But, children with hand, foot, and mouth disease may shed the virus from the respiratory tract (nose, mouth and lungs) for 1-3 weeks and in the stool for weeks to months after the infection starts.
What is the effect of hand, foot, and mouth disease?Symptoms of hand, foot, and mouth disease usually include fever, mouth sores, and skin rash. The rash is commonly found on the hands and feet. Hand, foot, and mouth disease is common in infants and children younger than 5 years old. Most children have mild symptoms for 7 to 10 days.
Can hand foot and mouth affect other parts of the body?“Much like its name suggests, hand, foot, and mouth disease (HFMD) is caused by a contagious virus that classically affects your hands, feet, and mouth, but can actually cause a bumpy or blistery rash all over your body,” stated Lori Noble, MD, physician at Spruce Internal Medicine.
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Hand foot and mouth disease after effect
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