Hand, foot, and mouth disease in adults caused by <i>Coxsackievirus B1-B6</i>

Di Prinzio, Anama; Bastard, Dolores Pilar; Torre, Ana Clara; Mazzuoccolo, Luis Daniel

doi:10.1016/j.abd.2021.03.012

Anama Di Prinzio

Department of Dermatology, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina

https://orcid.org/0000-0003-2660-0357

Dolores Pilar Bastard

Department of Dermatology, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina

https://orcid.org/0000-0002-1994-922X

Ana Clara Torre ^∗∗Corresponding author. E-mail:anama.diprinzio@hospitalitalianodebuenosaires.org.ar (A.C. Torre).

Department of Dermatology, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina

https://orcid.org/0000-0001-9670-6566

Luis Daniel Mazzuoccolo

Department of Dermatology, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina

https://orcid.org/0000-0002-6315-7916

∗Corresponding author. E-mail:anama.diprinzio@hospitalitalianodebuenosaires.org.ar (A.C. Torre).

Authors' contributions

Anama Di Prinzio: Critical literature review; data collection, analysis, and interpretation; effective participation in research orientation; intellectual participation in propaedeutic and/or therapeutic management of studied cases; intellectual participation in propaedeutic and/or therapeutic management of studied cases; study conception and planning.

Dolores Pilar Bastard: Critical literature review; study conception and planning.

Ana Clara Torre: Effective participation in research orientation; intellectual participation in propaedeutic and/or therapeutic management of studied cases; intellectual participation in propaedeutic and/or therapeutic management of studied cases; manuscript critical review; study conception and planning.

Luis Daniel Mazzuoccolo: Approval of the final version of the manuscript; manuscript critical review.

Conflicts of interest

None declared.

	Patient 1	Patient 2	Patient 3
Gender	Male	Male	Male
Age (years)	33	39	21
Epidemiological Background	-	Daughter with HFMD, 1 week before	-
Skin Lesions	Oral enanthema and painful maculopapular rash	Multiple purpuric macules and papules, itchy and isolated blisters	Oral enanthema and oral ulcers, multiple erythematous papules, and itchy and painful blisters
Location of Skin Lesions	Scalp, face, chest, hands, and feet (Fig. 1)	Scalp, face, auricular pavilions, hands, thighs, and feet (Fig. 2)	Oral mucosa, back of the tongue, and hard palate. Armpits, elbows, hands, and feet (Fig. 3)
Systemic Symptoms	Fever, odynophagia, and general malaise	Fever, myalgia, and bilateral orchitis	Odynophagia
Presumptive Diagnosis	Syphilis and HFMD	Syphilis, HFMD, and blistering diseases	Syphilis, HFMD, milker's nodules, blistering diseases, and Kaposi's chickenpox-like rash
Laboratory	No changes	Leukocytosis (12000/mm³)	Leukocytosis (13100/mm³)
Serologies	VDRL and HIV non-reactive	HCV, HBV, VDRL, HIV, CMV, EBV, and Parvovirus non-reactive	HCV, HBV, VDRL, HIV, CMV, EBV, HSV, HZV, Mycoplasma, and Parvovirus non-reactive.
Serologies	IgM for Coxsackie virus B1-B6 reactive	IgM for Coxsackie virus B1-B6 reactive	IgG for Coxsackie virus with 4× titer increase 15 days later
Skin Biopsy	-	Compatible with viral infection, probable HFMD (Fig. 4)	Compatible with viral infection, probable HFMD
Diagnosis	Serological	Serological and histological	Serological and histological
Treatment	NSAIDS	NSAIDS and wet treatments of denuded blisters	NSAIDS and gargles with lidocaine
Clinical Progress	Resolution in 10 days	Resolution in 15 days	Resolution in 20 days
Complications	-	Onycholysis on hands and feet (2 months later)	-

[1] ∗Corresponding author. E-mail:anama.diprinzio@hospitalitalianodebuenosaires.org.ar (A.C. Torre).

Brasil

Brasil

Hand, foot, and mouth disease in adults caused by Coxsackievirus B1-B6^☆ ☆ Study conducted at the Department of Dermatology, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.

Abstract

Brasil

Brasil

Hand, foot, and mouth disease in adults caused by Coxsackievirus B1-B6☆ ☆ Study conducted at the Department of Dermatology, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.

Abstract

Hand, foot, and mouth disease in adults caused by Coxsackievirus B1-B6^☆ ☆ Study conducted at the Department of Dermatology, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.