Unusual nail alterations in a child: a consequence of a common infection (a case report)

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DOI:

https://doi.org/10.32385/rpmgf.v39i2.13553

Palavras-chave:

Hand-foot-and-mouth disease, Nails, malformed, Case reports

Resumo

Introduction: Onychomadesis refers to the proximal separation of the nail plate from the matrix following a temporary arrest in nail formation, leading to nail shedding. While it can be a consequence of multiple aetiologies, it is uncommon in childhood. To our knowledge, this is the first case reporting the association between onychomadesis and hand-foot-and-mouth disease in the context of primary health care in Portugal.

Case description: A previously healthy 21-month-old male child, otherwise asymptomatic except for fingernail alterations, was diagnosed with hand-foot-and-mouth disease four weeks before nail changes.

Comment: Beau’s lines and onychomadesis are late complications of hand-foot-and-mouth disease. Clinicians must invest in a proper and detailed patients medical history and assess recent viral infections. On the other hand, the knowledge of probable indicators and of the association between onychomadesis and hand-foot-and-mouth disease itself may avoid inadequate investigations, referrals, and treatments. Furthermore, advising and reassuring patients/parents/caregivers about possible nail alterations weeks following hand-foot-and-mouth disease may also prevent unnecessary concerns.

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Referências

Hardin J, Haber RM. Onychomadesis: literature review. Br J Dermatol. 2015;172(3):592-6.

Hassan S. Onychomadesis (nail shedding) secondary to enterovirus herpangina like infection and without the skin manifestations of hand foot mouth disease. Am J Pediatr. 2019;5(3):78-81.

Clementz GC, Mancini AJ. Nail matrix arrest following hand-foot-mouth disease: a report of five children. Pediatr Dermatol. 2000;17(1):7-11.

European Centre for Disease Prevention and Control. Epidemiological update on hand, foot and mouth disease in Asia, May 2012 [homepage]. Solna: ECDC; 2012 May 29. Available from: https://www.ecdc.europa.eu/en/news-events/epidemiological-update-hand-foot-and-mouth-disease-asia-may-2012

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. 2020;30(2):e2087.

Guerra AM, Orille E, Waseem M. Hand foot and mouth disease [Internet]. Treasure Island: StatPearls Publishing; 2022. Available from: https://www.ncbi.nlm.nih.gov/books/NBK430685/

Esposito S, Principi N. Hand, foot and mouth disease: current knowledge on clinical manifestations, epidemiology, aetiology and prevention. Eur J Clin Microbiol Infect Dis. 2018;37(3):391-8.

Bernier V, Labrèze C, Bury F, Taïeb A. Nail matrix arrest in the course of hand, foot and mouth disease. Eur J Pediatr. 2001;160(11):649-51.

Guimbao J, Rodrigo P, Alberto MJ, Omeñaca M. Onychomadesis outbreak linked to hand, foot, and mouth disease, Spain, July 2008. Euro Surveill. 2010;15(37):19663.

López Davia J, Hernández Bel P, Zaragoza Ninet V, Alma Bracho M, González-Candelas F, Salazar A, et al. Onychomadesis outbreak in Valencia, Spain associated with hand, foot, and mouth disease caused by enteroviruses. Pediatr Dermatol. 2011;28(1):1-5.

Apalla Z, Sotiriou E, Pikou O, Lefaki I, Lallas A, Lazaridou E, et al. Onychomadesis after hand-foot-and-mouth disease outbreak in northern Greece: case series and brief review of the literature. Int J Dermatol. 2015;54(9):1039-44.

Yan X, Zhang ZZ, Yang ZH, Zhu CM, Hu YG, Liu QB. Clinical and etiological characteristics of atypical hand-foot-and-mouth disease in children from Chongqing, China: a retrospective study. Biomed Res Int. 2015;2015:802046.

Li J, Zhu R, Huo Da, Du Y, Yan Y, Liang Z, et al. An outbreak of Coxsackievirus A6-associated hand, foot, and mouth disease in a kindergarten in Beijing in 2015. BMC Pedriatr. 2018;18(1):277.

Kuehnel NA, Thach S, Thomas DG. Onychomadesis as a late complication of hand-foot-mouth disease: a case series shedding light on nail shedding. Pediatr Emerg Care. 2017;33(11):e122-e3.

Osterback R, Vuorinen T, Linna M, Susi P, Hyypiä T, Waris M. Coxsackievirus A6 and hand, foot and mouth disease, Finland. Emerg Infect Dis. 2009;15(9):1485-8.

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Publicado

2023-05-03

Como Citar

Silva, J. M. R., & Varandas, P. (2023). Unusual nail alterations in a child: a consequence of a common infection (a case report). Revista Portuguesa De Medicina Geral E Familiar, 39(2), 159–63. https://doi.org/10.32385/rpmgf.v39i2.13553