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PubMed2001

Nail matrix arrest in the course of hand, foot and mouth disease.

UNLABELLED: Onychomadesis describes complete nail shedding from the proximal portion; it is consecutive to a nail matrix arrest and can affect both fingernails and toenails. It is a rare disorder in children. Except for serious generalised diseases or inherited forms, most cases are considered to be idiopathic. Few reports in literature concern common triggering phenomena. We present four patients in whom the same benign viral condition in childhood appeared as a stressful event preceding onychomadesis. In each case, spontaneous complete healing of the nails was achieved within a few weeks. CONCLUSION: Onychomadesis and/or onycholysis is a newly recognised complication in the course of viral infections presenting clinically as hand, foot and mouth disease, and because of mild forms, is probably underestimated.

Adolescent↗
PubMedDate not supplied

The hand-foot syndrome--a frequent secondary manifestation in antineoplastic chemotherapy.

The hand-foot syndrome (HFS) (palmoplantar erythrodysesthesia) designates acute, painful erythemas of the palms and soles of the feet caused by antineoplastic chemotherapies. The most frequent trigger substances are 5-fluoruracil and its derivates. At maximum severity, the HFS is bullous to erosive or ulcerous in character. The pathogenesis has not yet been clarified. Histologically, the HFS is characterized by a toxic keratinocyte reaction. Furthermore, there is sub-basal edema with a tendency to bullae, dilated blood and lymph capillaries and usually only mild perivascular lymphocytic infiltration. Early recognition and delineation from other differential diagnoses is prerequisite to targeted management of the disease. Depending on the severity, HFS requires dose reduction, interruption or switch in the antineoplastic chemotherapy.

Antineoplastic Agents↗
PubMed1989

[Hand-foot-mouth disease: its course in the city of Milan (1980-86). Epidemiologic study gathered from the records of the community and scholastic ambulatory services of the Istituto di Clinica Dermatologic I and Dermatologia Pediatrica of the University].

Hand-foot-mouth disease: the Authors describe the epidemiological observations in a period of seven years made in a big urban area of Milan. They point out the periodic course of hand-foot and mouth disease, which is present in particular during May and November and particularly in children under six years. The Authors point out the difference between males and females and they try to correlate their dates with those gathered from the study of the literature.

Adolescent↗
PubMed1997

[Serotype determination of enteroviruses that cause hand-foot-mouth disease; identification of enterovirus 71 and coxsackievirus A16 from clinical specimens by using specific probe].

Coxsackievirus A16 (CA16) and enterovirus 71 (EV71) are known to be major causative agents of hand-foot-and-mouth disease prevalent in summer in Japan. Discrimination and identification of these viruses were often hampered by a nonneutralizable or nontypable virus. Therefore, a Southern blot hybridization that utilizes mixed probes specific to serotype was developed. Firstly, an approximately 650 bases spanning 5'-noncoding region to one third of VP2 including entire VP4 was amplified with a set of primers containing enterovirus common sequences and a genomic RNA as template. Secondary, the nucleotide sequences were determined using seven CA16 and eighteen EV71 strains including the standard strains, and the deduced amino acid sequences of VP4 were searched to find residues which are conserved in the same serotypes but diverged among different serotypes. Candidate positions for the mixed probes were defined at the carboxyl terminus of VP4. Thirdly, Southern blot analyses were carried out using thirty-nine enterovirus standard strains, seven CA16 isolates and sixty-six EV71 isolates previously identified by the neutralization test. The results revealed that each mixed probe exclusively bound to the homologous DNAs but not to the heterologous ones. In an attempt to determine serotypes without virus isolation, clinical specimens from hand-foot-and-mouth disease were examined. Of 78 throat swabs and 15 vesicular fluids, 71 (91.0%) and 13 (86.7%) specimens were clearly identified, indicating that the method described here offer advantages over the traditional neutralization assay: It is rapid, specific and less labor-consuming.

Amino Acid Sequence↗
PubMed2003

Hand, foot and mouth disease in an immunocompromised adult treated with aciclovir.

A 27-year-old man, immunosuppressed from recent chemotherapy for metastatic Ewing's sarcoma, presented with a 1-week history of a painful, pruritic, papulovesicular eruption on the hands and feet. A diagnosis of hand, foot and mouth disease was made based on histology, detection of Enterovirus ribonucleic acid by polymerase chain reaction on a swab from a vesicle, and a four-fold increase in Enterovirus antibody levels. At no stage however, were there lesions in the mouth. Another unusual feature in this case was a prolonged course, presumably as a result of immunosuppression. After 3 1/2 weeks he was commenced on oral aciclovir 200 mg five times daily, with subsequent resolution of all lesions within 5 days. There may be a role for systemic aciclovir in some patients with hand, foot and mouth disease.

Acyclovir↗
PubMed1982

[Hand, foot and mouth disease. Report of 10 cases].

Ten children with hand-foot-and-mouth disease are described and their clinical manifestations reported in detail. It is a benign, minor viral disease of childhood, but in our country its real incidence is unknown. Diagnosis in the clinical practice is based on the recognition of typical and atypical localizations of the vesicular eruption, as well as on the identification of extracutaneous and extrabuccal manifestations. The differential diagnosis includes herpangina, aphthous stomatitis, dyshidrosis and erythema multiforme.

Child↗
PubMed1985

Electron microscopic demonstration of virus particles in hand, foot and mouth disease.

Early skin and oral mucous membrane lesions of hand, foot and mouth disease (HFMD) were biopsied and investigated by light and electron microscopy. Histology showed spongiosis, intraepidermal splits indicating beginning vesicle formation, exocytosis of lymphoid cells and macrophages, and individual necrotic keratinocytes. Electron microscopy revealed naked viruses with a mean diameter of 24 nm which were arranged in sheets in the cytoplasm. Many keratinocyte nuclei contained tonofibrils. Cellular injury ranged from slight cytoplasmic edema to keratinocyte necrosis. Some nuclei showed dissolution of the nuclear membrane and dislocation of cytoplasm into the nucleus.

Biopsy↗
PubMed1990

Hand-foot-genital syndrome: the importance of hallux varus.

The hand-foot-genital syndrome is an autosomal dominant disorder previously reported in six families. This report of the seventh family identified with this syndrome is presented to emphasize the frequent occurrence of medial deviation of the first toes (hallux varus).

Abnormalities, Multiple↗
PubMed2006

Laterality in persons with intellectual disability II. Hand, foot, ear, and eye laterality in persons with Trisomy 21 and Williams-Beuren syndrome.

Laterality (hand, foot, ear, and eye) was assessed in participants with Trisomy 21 (62) and Williams-Beuren syndrome (WBS) (39). Handedness was also assessed in a card reaching task. The comparison group included 184 typically developing persons. Two independent age sub-groups were formed: 7 to 10 years old and 11 to 34 years old. We confirmed previous data: individuals with T21 were more frequently left- or mixed-handed than typically developing persons; individuals with WBS had intermediate scores. The two groups with genetic disorders had less right foot preference. Manual and foot inconsistencies characterized both groups with genetic disorders. Cross hand-foot preference was lower in the typically developing group. Differences in IQ levels did not correlate with differences in laterality scores. Overall laterality profiles were not the same in the two groups with genetic disorders: the greatest differences were observed between typically developing persons and persons with Trisomy 21.

Adolescent↗
PubMed2000

Neurological manifestations of enterovirus 71 infection in children during an outbreak of hand, foot, and mouth disease in Western Australia.

Enterovirus 71 (EV71) causes epidemics of hand, foot, and mouth disease associated with neurological complications in young children. We report an outbreak of EV71-associated neurological disease that occurred from February through September 1999 in Perth, Western Australia. Fourteen children with culture-proven, EV71-induced neurological disease were identified. Nine patients (64%) developed severe neurological disease; 4 of these patients developed long-term neurological sequelae. Neurological syndromes included aseptic meningitis, Guillain-Barré syndrome, acute transverse myelitis, acute cerebellar ataxia, opso-myoclonus syndrome, benign intracranial hypertension, and a febrile convulsion. Clinical and magnetic resonance imaging data indicated that immunopathology was a major factor in the pathogenesis of neurological disease in this outbreak. This finding is in contrast to reports of previous EV71 epidemics, in which virus-induced damage to gray matter was the most frequent cause of neurological disease.

Acute Disease↗
PubMed1983

A clustering outbreak of hand, foot, and mouth disease caused by Coxsackie virus A10.

A clustering outbreak of hand, foot, and mouth disease (HFMD) occurred from July, 1981 to January, 1982 in Matsue City and Gotsu City, Shimane Prefecture. Thirty-seven patients with clinical HFMD were virologically and serologically examined, and Coxsackie virus A10 (CA10) was isolated in 18 patients from vesicles (7/16), throat-swabs (9/31) and feces (6/7). During the period, no CA16 or enterovirus 71 were isolated from HFMD patients or from other diseases such as pharyngitis, febrile diseases, and aseptic meningitis. Serological diagnosis was performed employing an African green monkey kidney cell (AG-1)-adapted CA10 which demonstrated cytopathogenic effects on the cells. Paired sera from seven patients including three cases in which isolation failed showed a significant increase of neutralizing antibody titer against CA10. Finally, an etiological diagnosis was made in 21 out of 37 patients with clinical HFMD. This is the first report of a clustering outbreak of HFMD caused by CA10 in Japan.

Antibodies, Viral↗
PubMed2002

Change of major genotype of enterovirus 71 in outbreaks of hand-foot-and-mouth disease in Taiwan between 1998 and 2000.

Two outbreaks of hand-foot-and-mouth disease (HFMD) occurred in Taiwan between 1998 and 2000. Enteroviruses were isolated from a total of 1,892 patients in this laboratory during this period. Of the virus isolates, enterovirus 71 (EV71) was diagnosed in 44.4% of the patients (132 of 297) in 1998, 2% (13 of 646) in 1999, and 20.5% (195 of 949) in 2000. Genetic analyses of the 5'-untranslated and VP1 regions of EV71 isolates by reverse transcription-PCR and sequencing were performed to understand the diversity of EV71 in these outbreaks of HFMD. Most EV71 isolates from the 1998 epidemic belonged to genotype C, while only one-tenth of the isolates were genotype B. Interestingly, all EV71 isolates tested from 1999 to 2000 belonged to genotype B. This study indicated that two genogroups of EV71 capable of inducing severe clinical illness have been circulating in Taiwan. Furthermore, the predominant EV71 genotypes responsible for each of the two major HFMD outbreaks within the 3-year period in Taiwan were different.

5' Untranslated Regions↗
PubMed2003

[Hand, foot and mouth disease, a not so benign affection: clinical reminder and potential complications].

Hand-foot-and-mouth disease is an infection appearing in epidemics and due, in most cases, to Coxsackie-virus A16 and/or Enterovirus 71 or, less often, to other Coxsackie-virus serotypes. The symptomatology mostly consists in vesicular eruption of the anterior part of the buccal mucosa as well as of hands and feet. Its evolution, although often benign, can include cardiopulmonary and neurological complications. The latter complications require a quickly detection and treatment, and prevention of virus transmission to other people must be adequate.

Cardiovascular Diseases↗
PubMed1986

[Stapes anomaly, Gorlin-Goltz and hand-foot-uterus syndrome as partial aspects of a generalized ectodermal-mesodermal abnormality syndrome with variable expression].

A case of a Gorlin-Goltz-syndrome with anomalies of the stapes and incus of one ear is described for the first time. In the reported case, the hand-foot-uterus-syndrome could be recognised simultaneously. In the literature, about 250 cases of the syndrome are known, first published by Gorlin and Goltz in 1960. Malformations of the middle ear, however, have not yet been described in the Gorlin-Goltz-syndrome. As in the reported case both of the syndromes, the Gorlin-Goltz-syndrome and the hand-foot-uterus-syndrome, could be diagnosed, it must be discussed whether there are two independent syndromes or only one syndrome of polyvalent malformations characterised by variable expressivity.

Adult↗
PubMed2026

Genetic Variation and Evolutionary Characteristics of Coxsackievirus B1: F3 Subtype Associated With Hand, Foot and Mouth Disease in China.

Coxsackievirus B1 (CV-B1) is primarily associated with meningitis but can also cause localized outbreaks of hand, foot, and mouth disease (HFMD). This study analyzed the genetic diversity of the VP1 gene in 39 strains of the CVB1 virus isolated from HFMD children across 15 provinces in China between 2010 and 2024, as well as 179 strains from 17 countries. Based on the average nucleotide difference of VP1 gene, we classified CVB1 virus into six genotypes A to F, Notably, genotype F is newly classified. Since 2010, genotype F guadually replaced genotype E as the dominant genotype in China and has further subdivided into three subtypes: F1, F2, and F3, with F3 being the most prevalent subtype in China currently. We specifically study the mild and severe cases within the F3 subtype. Temperature-sensitivity experiments revealed no differences between mild and severe cases of the F3 subtype, and they all belong to temperature-sensitive strains. Interestingly, we found that mild cases of the F3 subtype did not involve recombination, whereas all severe cases of the F3 subtype showed recombination with Coxsackievirus B4 (CVB4). CVB4 has consistently been the primary pathogen responsible for severe neonatal illnesses, suggesting that recombination between the F3 subtype and CVB4 may be associated with the development of severe HFMD. These findings provide fundamental scientific data for further investigation into the epidemiology and genetic characteristics of variants of Coxsackievirus B1 in China.

Humans↗
PubMed1991

[Hand, foot and mouth disease].

The authors described a case of viral stomatitis of the type of hand, foot and mouth disease with mucosal and skin manifestations in an adult with a significant rise of neutralizing antibodies against the Coxsackie B4 virus.

Adult↗
PubMed1982

An outbreak of hand, foot, and mouth disease in Singapore.

Epidemiological studies were carried out during an extensive outbreak of hand, foot and mouth disease caused by coxsackievirus A 16 in Singapore in 1981. Most of the cases were concentrated in densely populated public housing estates, and the morbidity rate was highest in children under 5 years of age. The mean secondary attack rate for children under 12 years of age was 76.7% compared with an overall rate of 31.3%. The incubation period ranged from 1 to 7 days. Factors favouring the transmission of infection within a household included sharing of household and personal articles with the index case. The disease was mild and self-limiting.

Adolescent↗