Onychomadesis secondary to mouth, hand, and foot disease: Case report
Abstract
This case is about a previously healthy five-year-old girl who presented with hand, foot, and mouth disease, and subsequently developed onychomadesis one month later, with detachment of the nail plates on both fingers and toes. However, the condition resolved spontaneously.
After hand, foot, and mouth disease, she exhibited nail bed elevation at the proximal región of the nails on the second and third fingers of both hands. This elevation was painless, without bleeding, and later involved all toes. The condition resolved spontaneously over the following three months, with new, healthy nail growth.
In Latin America, onychomadesis is a rare complication of hand, foot, and mouth disease in our region and is associated with atypical forms of the disease, indicating altered host response to common infections with coxsackie viruses. Reporting such cases is essential to understand these benign and self-limited variations, prevent misdiagnoses, and inform parents appropriately.
Downloads
References
1. Lee DK, Lipner SR. Optimal diagnosis and management of common nail disorders. Ann Med. 2022;54:694-712. https://doi.org/10.1080/07853890.2022.2044511
2. Alghamdi A, Mazraani N, Alghamdi Y, Albugami SM. Onychomadesis and Beau’s line following hand-foot-and-mouth disease in a seven-year-old male. Cureus. 2022;14:e23832. https://doi.org/10.7759/cureus.23832
3. Smith RJ, Rubin AI. Pediatric nail disorders: A review. Curr Opin Pediatr. 2020;32:506-15. https://doi.org/10.1097/MOP.0000000000000921
4. Eguía Angeles HA, Sotelo García CO, Vadæle J, Rasmussen H, Eguía Angeles EA. Onychomadesis in an immunocompetent adult patient. Semergen. 2018;44:e85-6. https://doi.org/10.1016/j.semerg.2017.07.003
5. Chiu HH, Liu MT, Chung WH, Ko YS, Lu CF, Lan CC, et al. The mechanism of onychomadesis (Nail shedding) and Beau’s lines following hand-foot-mouth disease. Viruses. 2019;11:522. https://doi.org/10.3390/v11060522
6. Sharma A, Mahajan V, Mehta K, Chauhan P, Manvi S, Chauhan A. Hand, foot and mouth disease: A single centre retrospective study of 403 new cases and brief review of relevant Indian literature to understand clinical, epidemiological, and virological attributes of a longlasting Indian epidemic. Indian Dermatol Online J. 2022;13:310-20. https://doi.org/10.4103/idoj.idoj_701_21
7. Zhao TS, Du J, Sun DP, Zhu QR, Chen LY, Ye C, et al. A review and meta-analysis of the epidemiology and clinical presentation of coxsackievirus A6 causing hand-foot-mouth disease in China and global implications. Rev Med Virol. 2019;30:e2087. https://doi.org/10.1002/rmv.2087
8. Justino MCA, da S. Mesquita D, Souza MF, Farias FP, Jainara JC, Ferreira JL, et al. Atypical hand-foot-mouth disease in Belém, Amazon region, northern Brazil, with detection of coxsackievirus A6. J Clin Virol. 2020;126:104307. https://doi.org/10.1016/j.jcv.2020.104307
9. Li D, Wu Y, Xing X, Huang J, Mao A, Liu T, et al. Onychomadesis and potential association with HFMD outbreak in a kindergarten in Hubei province, China, 2017. BMC Infect Dis. 2019;995. https://doi.org/10.1186/s12879-019-4560-8
10. Saguil A, Kane SF, Lauters R, Mercado MG. Hand-foot-and-mouth disease: Rapid evidence review. Am Fam Physician. 2019;100:408-14.
11. Wong SS, Yip CC, Lau SK, Yuen KY. Human enterovirus 71 and hand, foot, and mouth disease. Epidemiol Infect. 2010;138:1071-89. https://doi.org/10.1017/S0950268809991555
12. Cui Y, Shi Q, Song P, Tong J, Cheng Z, Zhang H, et al. Coxsackievirus A10 impairs nail regeneration and induces onychomadesis by mimicking DKK1 to attenuate Wnt signaling. J Exp Med. 2024;221:e20231512. https://doi.org/10.1084/jem.20231512
13. Giordano MC, de la Fuente A, Lorca MB, Kramer D. Onicomadesis secundaria a enfermedad pie-mano-boca: una manifestación frecuente y motivo de preocupación de los padres. Rev Chil Pediatr. 2018;89:380-3. https://doi.org/10.4067/s0370-41062018005000203
14. Li XW, Ni X, Qian SY, Wang Q, Jiang RM, Xu WB, et al. Chinese guidelines for the diagnosis and treatment of hand, foot, and mouth disease (2018 edition). World J Pediatr.2018;14:437-47. https://doi.org/10.1007/s12519-018-0189-8
15. Cheng FF, Zhang BB, Cao ML, Zhang Q, Chen QH, Hui ZF, et al. Clinical characteristics of 68 children with atypical hand, foot, and mouth disease caused by coxsackievirus A6: A single-center retrospective analysis. Transl Pediatr. 2022;11:1502-9. https://doi.org/10.21037/tp-22-352
Some similar items:
- Dioselina Peláez, Johanna Alexandra Rodríguez, Elva Lucía Rocha, Gloria Janeth Rey, Standardization of a method for concentration and detection of enteric viruses from drinking water , Biomedica: Vol. 30 No. 2 (2010)
- María Mercedes González, Alejandra María Giraldo, Liliana Quintero, Leonardo Padilla, Luis Sarmiento, Jhon Carlos Castaño, Prevalence of enterovirus infection in infants in Armenia, Colombia, 2009 , Biomedica: Vol. 31 No. 4 (2011)
- Dioselina Peláez, Blanca Lisseth Guzmán, Johanna Rodríguez, Felipe Acero, Gerardo Nava, Presence of enteric viruses in water samples for consumption in Colombia: Challenges for supply systems , Biomedica: Vol. 36 (2016): Suplemento 2, Enfermedades virales
- Mayra L. Lúa, Arturo Plascencia, Patricia Paredes, Yaxsier de Armas, Miguel Raygoza, Erika Martínez, Fernando Siller, Iván Isidro Hernández, Etiological identification of viral agents in acute encephalitis in Guadalajara, México, 2011-2015 , Biomedica: Vol. 38 No. 2 (2018)
- Germán Briceño, Jaime Céspedes, Martha Leal, Sarha Vargas, Prevalence of cardiovascular risk factors in schoolchildren from a rural and urban area in Colombia , Biomedica: Vol. 38 No. 4 (2018)
- Daniela Arturo-Terranova, Sebastián Giraldo-Ocampo, Andrés Castillo , Molecular characterization of Epstein-Barr virus variants detected in the oral cavity of adolescents in Cali, Colombia , Biomedica: Vol. 40 No. Supl. 1 (2020): Mayo, Infecciones en el trópico
- Gustavo Aroca, María Vélez-Verbel , Andrés Cadena , Lil Geraldine Avendaño , Sandra Hernández, Angélica Sierra, Omar Cabarcas, Santos Ángel Depine, COVID-19 in hemodialysis patients in Colombia: Report of seven cases , Biomedica: Vol. 40 No. Supl. 2 (2020): SARS-CoV-2 y COVID-19
- Adson Martins, Samara Santos, Claudia Lisboa, Tânia Barros, Tereza Ribeiro, Hugo da Costa-Ribeiro Jr., Ângela Mattos, Patrícia Mendes, Carlos Mendes, Edna Souza, Ana Amor, Neci Soares, Márcia Cristina Aquino Teixeira, Infectious etiology and indicators of malabsorption or intestinal injury in childhood diarrhea , Biomedica: Vol. 44 No. 1 (2024)
Copyright (c) 2025 Biomedica
This work is licensed under a Creative Commons Attribution 4.0 International License.
| Article metrics | |
|---|---|
| Abstract views | |
| Galley vies | |
| PDF Views | |
| HTML views | |
| Other views | |
