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Arising Concerns of Atypical Manifestations in Patients with Hand, Foot, and Mouth Disease

Yu Chen1, Bowen Dai1, Shujie Han1

  • 1Department of Epidemiology, College of Public Health, Zhengzhou University, Zhengzhou 450001, China.

Vaccines
|February 28, 2023
PubMed

Insights

Hand, foot, and mouth disease (HFMD) presents with varied atypical forms, often caused by Coxsackievirus A6. Recognizing these diverse presentations is crucial for accurate diagnosis and preventing complications.

Area of Science:

  • Infectious Diseases
  • Dermatology
  • Public Health

Background:

  • Hand, foot, and mouth disease (HFMD) is a common febrile illness in children.
  • Atypical presentations of HFMD, particularly those caused by Coxsackievirus A6 (CVA6), pose diagnostic challenges.
  • These atypical forms can mimic severe dermatological conditions, complicating clinical assessment.

Purpose of the Study:

  • To provide a comprehensive overview of atypical HFMD presentations.
  • To highlight the clinical features and diagnostic challenges associated with CVA6-induced HFMD.
  • To guide clinicians in accurate and timely diagnosis and management of atypical HFMD.

Main Methods:

  • Review of clinical investigations and differential diagnostics for atypical HFMD.
  • Summarization of data on the varied morphology and distribution of rashes in atypical HFMD.
  • Analysis of presentations mimicking other severe skin diseases.

Main Results:

  • Atypical HFMD, especially from CVA6, presents with diverse rashes (e.g., Gianotti-Crosti-like, eczema coxsackium, petechial/purpuric, vesiculobullous).
  • Differential diagnosis is complicated by mimicry of conditions like eczema herpeticum, varicella, and erythema multiforme major.
  • Timely recognition of distinguishing features is vital for appropriate care.

Conclusions:

  • Accurate diagnosis of atypical HFMD requires recognizing a wide spectrum of cutaneous and mucosal alterations.
  • Improved clinical diagnostic strategies are needed to address the challenges posed by atypical HFMD.
  • This review serves as a scientific guide for timely diagnosis and prevention of serious complications.
Keywords:
CVA6HFMDatypical manifestationsdifferential diagnosisgenetic evolution

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