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Nail changes in hand-foot-and-mouth disease (HFMD)

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 Submission18-Apr-2020
Date of Decision19-May-2020
Date of Acceptance22-Jun-2020
Date of Web Publication19-Sep-2020

Correspondence Address:
Shyam Verma,
Nirvana Skin Clinic, Makarpura Main Road, Vadodara, Gujarat - 390 015
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/idoj.IDOJ_271_20

How to cite this URL:
Verma S, Singal A. Nail changes in hand-foot-and-mouth disease (HFMD). Indian Dermatol Online J [Epub ahead of print] [cited 2021 Nov 27]. Available from: https://www.idoj.in/preprintarticle.asp?id=295438

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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   References Top

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.  Back to cited text no. 1
Nag SS, Dutta A, Mandal RK. Delayed cutaneous findings of hand, foot, and mouth disease. Indian Pediatr 2016;53:42-4.  Back to cited text no. 2
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.  Back to cited text no. 3


  [Figure 1], [Figure 2]


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