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Hand, Foot and Mouth:an acute viral illness characterized by vesicular…
Hand, Foot and Mouth:an acute viral illness characterized by vesicular eruptions in the mouth and papulovesicular lesions of the distal limbs.
Symptoms
mucocutaneous lesions appear 1 to 2 days after a prodromal period of fever, malaise, and myalgia; and last approximately 7 to 10 days with spontaneous resolution
commonly due to Coxsackie A16 virus, although other group A and B Coxsackie viruses
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Spread by direct contact with nasal and throat secretions, by direct contact from fluid in blisters and by faeco oral transmission
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Complications (Rare)
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Secondary bacterial infection of lesions is rare, but can occur
Rare serious, life-threatening neurological sequelae may be caused by the enterovirus, including encephalitis, aseptic meningitis, acute flaccid paralysis, and fatal neurogenic pulmonary oedema
Differential
Herpangina — presents with high fever, malaise, headache, and oral lesions, but has no associated exanthema (rash).
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Erythema multiforme/Stevens–Johnson syndrome — typically presents with target lesions on palms, soles, and distal limbs. Vesicles coalesce and ulcerate, and mucous membrane involvement can progress to life-threatening Stevens–Johnson syndrome.
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Kawasaki disease — a systemic vasculitis which primarily affects infants and young children; it causes fever, conjunctivitis, 'strawberry' tongue, peeling skin, polymorphous rash, and cervical lymphadenopathy. Rare complications include coronary artery dilatation and aneurysm formation.
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Traumatic ulcers — such as from ill-fitting dentures, thermal trauma, or buccal aspirin.
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Behçet's disease — typically recurrent aphthous stomatitis with genital ulceration, eye involvement, and skin lesions.
Pemphigus vulgaris or oral bullous pemphigoid — painful mouth ulcers are present, and skin lesions are usually evident elsewhere.
Treatment
Advice re fluid intake, analgesia for painful lesions if indicated
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Diagnosis
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Early symptoms- fever (38oC-39oC), malaise, loss of appetite, cough, abdominal pain and sore mouth. Rarely vomiting occurs when HFMD caused by enterovirus. Scattered ulcerative lesions of oral cavity occur within 1-2days. Macules and papules of hands and feet follow the oral lesions soon after. Buttocks and groin area may be affected. Lesions may be painful or asymptomatic