Onychomadesis secondary to hand-foot-mouth disease: a frequent manifestation and cause of concern for parents

Abstract

Introduction: Nail alterations in children are an important cause of parent anxiety and derive in multiple and unnecessary consultations. The onychomadesis corresponds to the complete and painless detachment of the nail plate from the proximal fold. This self-resolving nail finding has been described as a late complication of hand-foot-mouth disease, a frequent viral exanthema in the pediatric age.

Objective: To describe a classic pediatric case of hand-foot-mouth disease with subsequent onychomadesis.

Clinical Case: A 3-years-old male patient with an acute presentation of acute erythematous perioral papulo-vesicles, which extend to upper extremities and hands, buttocks, thighs and feet, asymptomatic, and without compromising general condition. Skin lesions resolve completely, but after one month, he develops detachment of the nails, with subsequent complete recovery.

Conclusions: The recognition of this association will allow primary care physicians to guide the parents about a benign and self-resolving process that may occur as part of the evolution of hand-foot-mouth disease, thus avoiding unnecessary anxiety, referral and treatments.