Joint diagnosis of pediatric and dermatology clinics: Prospective observation of thirty-nine patients with hand, foot and mouth disease

Abstract

Background and Design: Hand, foot and mouth disease (HFMD) is a childhood enteroviral eruptive disease presenting with fever and cutaneous and mucosal lesions. It is benign and generally resolves spontaneously, but may sometimes result in systemic involvement. The purpose of this study was to share our clinical experience concerning patients who were followed with the diagnosis of HFMD established by the pediatric and dermatology clinics.

Materials and Methods: We prospectively evaluated patients who attended our hospital with the complaints of fever and eruptions and received the diagnosis of HFMD based on the clinical findings between December 2014 and November 2015. Age, sex, month of presentation, presentation symptoms and duration of symptoms were investigated. Systemic and dermatological examination findings, laboratory results and tests such as echocardiography were reviewed.

Results: Thirty-nine patients were included; 19 (48.8%) were girl and 20 (51.2%) were boy. The mean age of the patients was 29.8 +/- 27.9 (6-155) months. Six (15.3%) patients were in the 0-12 month age group, while only 3 (7.8%) were older than 60 months. Presentations were most common in September, June and October. The most common presentation symptoms were eruptions on the hands and feet (100%), fever (82.1%) and oral aphthae (79.5%). The lesions were most commonly observed on the hands (94.9%, n=37) and feet (87.2%, n=34) and in the mouth (79.5%, n=31). Cardiac involvement was determined in 3 (7.7%) patients. Nail changes were observed during monitoring in 10 (25.6%) patients.

Conclusion: Our results show that the age of onset of HFMD in Turkey has decreased compared to that reported in the previous studies. Patients must be evaluated in detail in terms of clinical and laboratory findings showing severity of the disease. This study also shows that pediatricians/dermatologists collaboration is of great importance.