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Nail changes in hand-foot-and-mouth disease (HFMD)
Shyam Verma1, Archana Singal2
1 Nirvana Skin Clinic, Makarpura Main Road, Vadodara, Gujarat, India
2 Department of Dermatology and STD, University College of Medical Sciences and GTB Hospital, Delhi, India
| Date of Submission | 18-Apr-2020 |
| Date of Decision | 19-May-2020 |
| Date of Acceptance | 22-Jun-2020 |
| Date of Web Publication | 19-Sep-2020 |
Correspondence Address:
Shyam Verma,
Nirvana Skin Clinic, Makarpura Main Road, Vadodara, Gujarat - 390 015
India
 Source of Support: None, Conflict of Interest: None DOI: 10.4103/idoj.IDOJ_271_20
Hand-foot-and mouth disease (HFMD) is a mild, contagious viral infection of children caused by a group of coxsackieviruses chiefly coxsackievirus A16 and Human enterovirus 71. It is characterized by fever, erythematous papulovesicular eruptions over palms, soles, knees, buttocks, and oral mucosa. Characteristic nail changes, onychomadesis, Beau's lines and yellowish-orange discoloration of the nail plate involving multiple fingers [Figure 1] and toenails are observed 4-8 weeks after the disease onset.[1],[2] Nail changes are thought to occur due to temporary inhibition of nail matrix activity as a result of either direct inflammation from periungual HFMD lesions, the proliferation of virus in the nail matrix, or HFMD's systemic impact on the general condition.[3] No active intervention is required as changes tend to resolve spontaneously within 1-2 months [Figure 2]. | Figure 1: Onychomadesis and yellowish discoloration involving all fingernails
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 | Figure 2: Spontaneous remission of nail changes after 8 weeks with prominent Beau's lines
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Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
 References | |  |
| 1. | Long DL, Zhu SY, Li CZ, Chen CY, Du WT, Wang X. Late-onset nail changes associated with hand, foot, and mouth disease: A clinical analysis of 56 cases. Pediatr Dermatol 2016;33:424-8.  |
| 2. | Nag SS, Dutta A, Mandal RK. Delayed cutaneous findings of hand, foot, and mouth disease. Indian Pediatr 2016;53:42-4. |
| 3. | Chiu HH, Liu MT, Chung WH, Ko YS, Lu CF, Lan CE, et al. The mechanism of onychomadesis (nail shedding) and Beau's lines following hand-foot-mouth disease. Viruses 2019;11:522. |
[Figure 1], [Figure 2]
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