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Atypical Hand-Foot-Mouth Disease Associated with Coxsackievirus A6 Infection
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Sep 10 2013
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Source: J Am Acad Dermatol. 69(5):736-741.
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Alternative Title:J Am Acad Dermatol
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Description:Background
Hand, foot, and mouth disease (HFMD) is an acute viral illness commonly caused by coxsackievirus A16 (CV-A16) and enterovirus 71 infections. Recently, atypical HFMD has been reported in association with CV-A6, an uncommon enterovirus strain.
Objective
To describe the clinical features of atypical HFMD associated with CV-A6 infection and its diagnostic laboratory evaluation.
Methods
Patients presenting to our institution with history and examination suggestive of atypical HFMD from January 2012 to July 2012 were identified. Morphology and distribution of mucocutaneous lesions were recorded. Enterovirus infection was assessed by reverse transcriptase polymerase chain reaction of biologic specimens. Enterovirus type was determined by viral capsid protein 1 gene sequencing.
Results
Two adults and 3 children with atypical HFMD were identified. Four of 5 patients exhibited widespread cutaneous lesions. In 2 patients with a prior history of atopic dermatitis, accentuation in areas of dermatitis was noted. Associated systemic symptoms prompted 4 of 5 patients to seek emergency care, and both adults were hospitalized for diagnostic evaluation. Infection with CV-A6 was confirmed in all patients.
Limitations
This study is a case series from a single institution.
Conclusion
Consideration of the expanded range of cutaneous findings in atypical HFMD caused by CV-A6 infection may assist clinicians in diagnosis and management.
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Pubmed ID:24035209
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Pubmed Central ID:PMC5843477
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