What is hand, foot, and mouth disease? | Fig. 25.5 Hand, foot, and mouth disease. A, Vesicular stomatits. B, Typical lesions on palmar skin. The vesicular lesions are classically gray and often elliptical. | Hand, foot, and mouth disease (HFMD), or vesicular stomatitis with exanthem, is usually seen in infants or young children. Following a brief prodrome of fever, malaise, and sore throat, the characteristic enanthem develops. Red macules, vesicles, and ulcers may be seen on the buccal mucosa, tongue, palate, and pharynx (Fig. 25-5A). Lesions may also occur on the hands and feet (dorsal aspects, as well as the palms and soles) (Fig. 25-5B). HFMD is caused by one of several enteroviruses, most commonly coxsackievirus A16. It is highly contagious and spreads by direct contact via the oral–oral or oral–fecal route. Over the past 10 years, outbreaks of HFMD caused by enterovirus 71 have been reported in Asia and Australia. Although HFMD associated with coxsackievirus A16 infection is typically a mild illness, HFMD caused by enterovirus 71 has shown a higher incidence of neurologic involvement including fatal cases of encephalitis. |