Onychomadesis secondary to hand-foot-mouth disease

A report describes a case of a three-year-old male patient with an unremarkable past medical history who presented with a five-day history of microvesicular lesions with an erythematous rim. The lesion was told to first appear in the perioral area, which then extended to the hands, arms, buttocks, thighs, and feet. The patient was in good general condition and asymptomatic.

He received the diagnosis of hand-foot-and-mouth disease, with more extensive lesions than the usual clinical picture.

His parents were advised general moisturization and control measures for the child. The patient showed complete resolution of the skin lesions and remission without any residual lesions.

After one month, he presented with the complete proximal detachment of nail plates, which corresponded to the characteristic onychomadesis as a late complication of this viral disease. A few days after the initial consultation, his father presented a similar, milder eruptive skin condition, also with a subsequent detachment of his nails.

Father and son experienced onychomadesis in some fingernails and toenails, with complete detachment of nail plates. It, however, resolved spontaneously between six to eight weeks, with the growth of healthy new nails.

Giordano L MC, de la Fuente L A, Lorca J MB, Kramer H D. Onychomadesis secondary to hand-foot-mouth disease: A frequent manifestation and cause of concern for parents. Revista chilena de pediatría. 2018;89(3). http://dx.doi.org/10.4067/S0370-41062018005000203