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Privileged localisation: Atypical hand-foot-mouth disease at locus minoris resistentiae
Vanila Muthukannu1, Ariharasudhan Varadharajan2, Ramamoorthy Logamoorthy3
1Junior Resident, Department of Dermatology, Venereology and Leprosy, Sri Manakula Vinayagar Medical College and Hospital, Pondicherry, India.
Tropical Doctor
|November 20, 2025
Summary
Hand, foot, and mouth disease (HFMD) can appear atypically in children, particularly in areas like burn scars. These cases show HFMD lesions localized to healed scalds, indicating immune changes in scars can trigger infections.
Area of Science:
- Pediatrics
- Infectious Diseases
- Dermatology
Background:
- Hand, foot, and mouth disease (HFMD) is a common viral illness in children.
- Atypical presentations of HFMD can occur, especially in immunocompromised areas.
- Healed burn scars represent areas of potentially reduced local resistance.
Purpose of the Study:
- To report unusual cases of HFMD localized to healed burn scars.
- To highlight the potential for immune dysregulation in burn scars.
- To increase awareness of atypical HFMD presentations.
Main Methods:
- Case report of two children with HFMD.
- Clinical observation of lesion distribution.
- Review of relevant literature on HFMD and burn scar infections.
Main Results:
- Both patients presented with HFMD lesions primarily on hands and feet.
- Atypical HFMD lesions were exclusively observed within a previously healed scald burn area in both cases.
- The findings suggest healed burn scars may be susceptible to viral infections like HFMD.
Conclusions:
- Healed burn scars can exhibit immune dysregulation, predisposing them to infections.
- Atypical HFMD localization to burn scars is a rare but possible presentation.
- Clinicians should consider HFMD in children with lesions on burn scars, even with classic hand and foot involvement.
