What causes it?

HFMD is a common viral illness in children caused by coxsackie virus (usually coxsackie A-16) and other enteroviruses. It is most often seen in children between the ages of 1 and 4 but can be seen in older children and even adults. Transmission is usually fecal-oral but can be oral-oral as well.

What does it look like?

People with HFMD disease often have a prodrome of low-grade fever and malaise before developing any skin changes. The classic rash has red spots and blisters on the palms of the hands, soles of the feet, and in the mouth. The blisters are deep, have a grey appearance, and are often oval-shaped. They characteristically run along the skin lines on the fingers and toes. Patients can also have spots on the backs of the hands, tops of the feet, buttocks (especially in toddlers wearing diapers), and the knees. The mouth sores are often painful and can make it hard to eat and drink.  Several weeks to months after HFMD, some children will develop nail changes called onychomadesis, which cause the nail to lift from the proximal edge.

How is it treated?

In most cases the virus goes away in about a week with no treatment other than pain medication and encouraging the person to eat and drink. There have been outbreaks with more dangerous strains, but these are rare. Treatment is supportive with the use of analgesics such as acetaminophen, topical anesthetics for painful oral lesions, and fluid administration to prevent dehydration. Eating can be difficult, and many people find that soft, bland foods and especially cold foods like ice cream, or even frozen vegetables (served still frozen) are soothing.

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