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Klapproth H, Rauterberg J, Shabli S, Silling S, Böttcher S, von Stebut E, Fabri M. Papulovesikulöses Exanthem und ausgeprägter einseitiger Hörverlust bei einem 20‐jährigen Mann. J Dtsch Dermatol Ges 2024; 22:720-723. [PMID: 38730528 DOI: 10.1111/ddg.15363_g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2023] [Accepted: 01/06/2024] [Indexed: 05/13/2024]
Affiliation(s)
- Henning Klapproth
- Klinik für Dermatologie und Venerologie, Medizinische Fakultät, Universität zu Köln und Uniklinik Köln
| | - Jonas Rauterberg
- Klinik für Dermatologie und Venerologie, Medizinische Fakultät, Universität zu Köln und Uniklinik Köln
| | - Sami Shabli
- Klinik und Poliklinik für Hals-, Nasen- und Ohrenheilkunde, Kopf- und Halschirurgie, Medizinische Fakultät, Universität zu Köln und Uniklinik Köln
| | - Steffi Silling
- Institut für Virologie, Medizinische Fakultät, Universität zu Köln und Uniklinik Köln
| | - Sindy Böttcher
- Nationales Referenzzentrum für Poliomyelitis und Enteroviren, Robert Koch Institut, Berlin
| | - Esther von Stebut
- Klinik für Dermatologie und Venerologie, Medizinische Fakultät, Universität zu Köln und Uniklinik Köln
| | - Mario Fabri
- Klinik für Dermatologie und Venerologie, Medizinische Fakultät, Universität zu Köln und Uniklinik Köln
- Center for Molecular Medicine Cologne (CMMC), Medizinische Fakultät, Universität zu Köln
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Klapproth H, Rauterberg J, Shabli S, Silling S, Böttcher S, von Stebut E, Fabri M. Papulo-vesicular eruption and profound unilateral hearing loss in a 20-year-old man. J Dtsch Dermatol Ges 2024; 22:720-723. [PMID: 38581347 DOI: 10.1111/ddg.15363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2023] [Accepted: 01/06/2024] [Indexed: 04/08/2024]
Affiliation(s)
- Henning Klapproth
- Department of Dermatology and Venereology, Faculty of Medicine, University of Cologne, and University Hospital of Cologne, Cologne, Germany
| | - Jonas Rauterberg
- Department of Dermatology and Venereology, Faculty of Medicine, University of Cologne, and University Hospital of Cologne, Cologne, Germany
| | - Sami Shabli
- Department of Otorhinolaryngology, Head and Neck Surgery, Faculty of Medicine, University of Cologne, and University Hospital of Cologne, Cologne, Germany
| | - Steffi Silling
- Institute of Virology, Faculty of Medicine, University of Cologne, and University Hospital of Cologne, Cologne, Germany
| | - Sindy Böttcher
- National Reference Centre for Poliomyelitis and Enteroviruses, Robert Koch Institute, Berlin, Germany
| | - Esther von Stebut
- Department of Dermatology and Venereology, Faculty of Medicine, University of Cologne, and University Hospital of Cologne, Cologne, Germany
| | - Mario Fabri
- Department of Dermatology and Venereology, Faculty of Medicine, University of Cologne, and University Hospital of Cologne, Cologne, Germany
- Center for Molecular Medicine Cologne (CMMC), Faculty of Medicine, University of Cologne, Cologne, Germany
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Starkey SY, Mar K, Khaslavsky S, Seeburruth D, Khalid B, Virmani D, Lam JM, Mukovozov I. Atypical cutaneous findings of hand-foot-mouth disease in children: A systematic review. Pediatr Dermatol 2024; 41:23-27. [PMID: 37877202 DOI: 10.1111/pde.15461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Accepted: 10/08/2023] [Indexed: 10/26/2023]
Abstract
INTRODUCTION Hand-foot-mouth disease (HFMD) is a common childhood infectious disease. Atypical skin findings of HFMD, often associated with coxsackievirus A6 (CVA6), were first reported in 2008, with increasing reports worldwide since. Atypical lesions of HFMD often involve sites beyond the palms and soles and tend to have unusual, polymorphic morphology. METHODS A systematic review was conducted on clinical features and outcomes of pediatric HFMD with atypical cutaneous manifestations. RESULTS Eighty-five studies were included, representing 1359 cases with mean age 2.4 years and a male predominance of 61%. The most reported morphologies were vesicles (53%), papules (49%), and bullae (36%). Other morphologies included eczema herpeticum-like (19%), purpuric/petechial (7%), and Gianotti Crosti-like (4%). Common atypical sites included the arms and/or legs (47%), face (45%), and trunk (27%). CVA6 was identified in 63% of cases. Symptoms resolved in a mean of 10 days. Overall, 16% of cases received treatment, most commonly with acyclovir, intravenous antibiotics, or topical steroids. The most common complications were nail changes (21%) and desquamation (4%) which occurred a mean of 3 and 2 weeks after symptoms, respectively. CONCLUSION Due to unusual morphologies resembling other conditions, HFMD with atypical cutaneous findings may be misdiagnosed, leading to inappropriate and unnecessary investigations, hospitalization, and treatment. Greater awareness of atypical presentations of HFMD is warranted to improve patient care and counseling on infection control precautions.
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Affiliation(s)
- Samantha Y Starkey
- Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
- Nemours Children's Hospital Delaware, Wilmington, Delaware, USA
| | - Kristie Mar
- Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | | | | | - Bushra Khalid
- Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Divya Virmani
- Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
- Island Infectious Disease Consultants, Victoria, British Columbia, Canada
| | - Joseph M Lam
- Department of Dermatology and Skin Science, University of British Columbia, Vancouver, British Columbia, Canada
- BC Children's Hospital, Vancouver, British Columbia, Canada
| | - Ilya Mukovozov
- Department of Dermatology and Skin Science, University of British Columbia, Vancouver, British Columbia, Canada
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Cheng FF, Zhang BB, Cao ML, Zhang Q, Chen QH, Hui ZF, Tian JM, Yan WH. Clinical characteristics of 68 children with atypical hand, foot, and mouth disease caused by coxsackievirus A6: a single-center retrospective analysis. Transl Pediatr 2022; 11:1502-1509. [PMID: 36247893 PMCID: PMC9561509 DOI: 10.21037/tp-22-352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Accepted: 08/26/2022] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Hand, foot, and mouth disease (HFMD) caused by coxsackievirus A6 (CV-A6) has become prevalent in many parts of the world. It is commonly referred to as atypical HFMD which more likely to present as bullous lesions. Compared with traditional HFMD, its misdiagnosis rate is relatively high, which brings difficulties to clinical diagnosis. We retrospectively analyze the clinical characteristics of children with HFMD with bullous lesions caused by CV-A6. METHODS The study included 68 children with atypical HFMD caused by CV-A6 who were hospitalized from 2018 to 2020. Data of the children including age, sex, month of HFMD onset, the morphologies and distribution of rashes, the details of fever, the presence or absence of onychomadesis, and laboratory test results were analyzed and compared between an infant group (<1 year), a toddler group (1-<3 years), and a preschool group (3-<6 years). RESULTS Of the 68 children, 67 were younger than 5 years old, with a male to female ratio of 1.62:1. The disease peaked in the period from June to September. With 75.0% of the infant group had more than three kinds of rashes; 95.0% of the preschool group had rashes in more than five locations. These differences were statistically significant (P<0.05). All children had fever. The peak fever in the toddler group was lower (P=0.033). No critical cases were observed in any of the groups. Of the 61 children who were successfully followed up, 68.9% developed onychomadesis within 2-3 weeks. The proportion of cases with abnormal liver function was 83.3%, 41.7%, and 10.0% in the infant, toddler, and preschool groups (P<0.001). The proportion of cases with increased serum creatine kinase MB isoenzyme (CK-MB) were significantly higher in the toddler group (P<0.05). CONCLUSIONS Atypical HFMD caused by CV-A6 infection usually occurred in children under 5 years old. The morphologies of the rashes in the infant group changed more, while the rashes in the preschool group was more widely distributed. The incidence of critical cases was low. More than half of the cases can develop onychomadesis in the recovery period. Organ damage was relatively mild in the preschool group.
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Affiliation(s)
- Fang-Fang Cheng
- Infectious Diseases Department, Children's Hospital of Soochow University, Suzhou, China
| | - Bing-Bing Zhang
- Neurology Department, Children's Hospital of Soochow University, Suzhou, China
| | - Meng-Lu Cao
- Infectious Diseases Department, Children's Hospital of Soochow University, Suzhou, China
| | - Qian Zhang
- Infectious Diseases Department, Children's Hospital of Soochow University, Suzhou, China
| | - Qing-Hui Chen
- Infectious Diseases Department, Children's Hospital of Soochow University, Suzhou, China
| | - Zhao-Fang Hui
- Infectious Diseases Department, Children's Hospital of Soochow University, Suzhou, China
| | - Jian-Mei Tian
- Infectious Diseases Department, Children's Hospital of Soochow University, Suzhou, China
| | - Wen-Hua Yan
- Cardiovascular Department, Children's Hospital of Soochow University, Suzhou, China
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Bopp L, Kreuter A, von Stebut E, Fabri M. [Virus-induced exanthems in returning travellers]. Hautarzt 2022; 73:462-474. [PMID: 35554622 PMCID: PMC9100320 DOI: 10.1007/s00105-022-05001-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/07/2022] [Indexed: 10/25/2022]
Abstract
Dermatological diseases are among the most common travel-associated diseases. In particular, viral infections not only with tropical and subtropical pathogens, but also with viruses common in Germany, which are often accompanied by skin rashes and general symptoms, are of great importance. In addition to an accurate travel history and possible risk exposures, epidemiological information on country-specific risks in combination with molecular and serological analyses is helpful in making the correct diagnosis. This article provides an overview of important virus-induced exanthems in returned travellers.
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Affiliation(s)
- Luisa Bopp
- Medizinische Fakultät und Uniklinik Köln, Klinik für Dermatologie und Venerologie, Universität zu Köln, Kerpener Str. 62, 50937, Köln, Deutschland.
| | - Alexander Kreuter
- Klinik für Dermatologie, Venerologie und Allergologie, HELIOS St. Elisabeth Klinik Oberhausen, Universität Witten/Herdecke, Oberhausen, Deutschland
| | - Esther von Stebut
- Medizinische Fakultät und Uniklinik Köln, Klinik für Dermatologie und Venerologie, Universität zu Köln, Kerpener Str. 62, 50937, Köln, Deutschland
| | - Mario Fabri
- Medizinische Fakultät und Uniklinik Köln, Klinik für Dermatologie und Venerologie, Universität zu Köln, Kerpener Str. 62, 50937, Köln, Deutschland
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Knop M, Alelq N, Kubieniec ME, Giehl K. [Palmoplantar dermatoses in children]. Hautarzt 2021; 72:215-224. [PMID: 33580281 DOI: 10.1007/s00105-021-04765-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/13/2021] [Indexed: 10/22/2022]
Abstract
Dermatoses of the hands and feet cover a wide range of skin diseases that can occur in children and adolescents and are a frequent question in dermatological practice. Our synopsis of the most important differential diagnoses and their treatment is intended to provide better orientation for daily practice. A precise and detailed history is essential to establish a diagnosis, followed by clinical examination and specific examination methods. Cutaneous infection should always be excluded, as they occur very frequently. Impetigo, punctate keratolysis, blistering distal dactylitis, tinea manuum and pedum, hand-foot-mouth disease, herpes simplex digitalis and verrucae vulgaris as well as scabies are often found in the palmoplantar area and typically affect children and adolescents. In case of allergic contact dermatitis and dyshidrotic eczema, atopic diathesis in the medical history is of importance. However, we must not miss rare causes. Palmoplantar keratoses, for example, can be due to inflammatory dermatoses like pityriasis rubra pilaris (PRP) or may, as well as blistering diseases, result from hereditary disorders. Specialised centers can perform molecular genetic diagnosis and enhance patient care.
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Affiliation(s)
- M Knop
- Klinik und Poliklinik für Dermatologie und Allergologie, Klinikum der Universität München LMU, Frauenlobstr. 9-11, 80337, München, Deutschland
| | - N Alelq
- Klinik und Poliklinik für Dermatologie und Allergologie, Klinikum der Universität München LMU, Frauenlobstr. 9-11, 80337, München, Deutschland
| | - M E Kubieniec
- Klinik und Poliklinik für Dermatologie und Allergologie, Klinikum der Universität München LMU, Frauenlobstr. 9-11, 80337, München, Deutschland
| | - K Giehl
- Klinik und Poliklinik für Dermatologie und Allergologie, Klinikum der Universität München LMU, Frauenlobstr. 9-11, 80337, München, Deutschland.
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