Eczema Coxsackium: An Unusual Presentation in Atopic Dermatitis and Hand, Foot, and Mouth Disease

Logan R Smith1, Helana Ghali1, Jessica Creech2

  • 1University of South Florida, Morsani College of Medicine.

Pediatric Annals
|December 2, 2025
PubMed

Insights

Eczema coxsackium, a severe hand, foot, and mouth disease variant, can present atypically in infants with atopic dermatitis. Early recognition is key for managing this viral exanthem, especially in children with eczema.

Area of Science:

  • Pediatrics
  • Dermatology
  • Infectious Diseases

Background:

  • Eczema coxsackium is a severe form of hand, foot, and mouth disease.
  • It is primarily caused by coxsackievirus A6 and A16.
  • This condition predominantly affects children with atopic dermatitis.

Purpose of the Study:

  • To report an atypical case of eczema coxsackium in an infant.
  • To highlight the importance of considering eczema coxsackium in the differential diagnosis of viral exanthems in children with atopic dermatitis.

Main Methods:

  • Case report of an 8-month-old infant with a history of atopic dermatitis.
  • Diagnosis based on clinical findings and patient history.

Main Results:

  • The infant presented with a widespread rash and prolonged fevers, lacking typical oral lesions.
  • This presentation was considered atypical for eczema coxsackium.

Conclusions:

  • Eczema coxsackium can manifest atypically, even without classic oral involvement.
  • Clinicians should consider eczema coxsackium in the differential diagnosis of viral rashes in atopic children.

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