Hand-foot-and-mouth disease physical examination

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Jesus Rosario Hernandez, M.D. [2], Aravind Kuchkuntla, M.B.B.S [3]

Overview

Hand foot mouth disease is one of many infections that result in mouth sores. Another common cause is oral herpesvirus infection, which produces an inflammation of the mouth and gums (sometimes called stomatitis). Usually, the physician can distinguish between HFMD and other causes of mouth sores based on the age of the patient, the pattern of symptoms reported by the patient or parent, and the appearance of the rash and sores on examination.

Physical examination

Common physical examination findings of hand-foot and mouth disease include:^[1]^[2]

General Apperance

Patient will appear ill with fever

HEENT

Lesions in the mouth:

Irregularly shaped shallow ulcers with yellow-grey base and hyperemic margin.^[3]
Location of the ulcers include:
- Margings of tongue
- Inside of cheeks
- Anterior fauces
- On the mandible above the posterior molar teeth
- Soft palate

Skin

Vesicular skin lesions on hand , foot (dorsum of the fingers and toes near the nail margins, and on heels) and sometimes on the buttocks.

Vesicular skin lesions usually do not occur on palms and soles but if they do occur, they are profuse, smaller and more uniform in size.

Gallery

Head

Extremities

References

↑ ALSOP J, FLEWETT TH, FOSTER JR (1960). ““Hand-foot-and-mouth disease” in Birmingham in 1959″. Br Med J. 2 (5214): 1708–11. PMC 2098292. PMID 13682692.
↑ Repass GL, Palmer WC, Stancampiano FF (2014). “Hand, foot, and mouth disease: identifying and managing an acute viral syndrome”. Cleve Clin J Med. 81 (9): 537–43. doi:10.3949/ccjm.81a.13132. PMID 25183845.
↑ Hubiche T, Schuffenecker I, Boralevi F, Léauté-Labrèze C, Bornebusch L, Chiaverini C; et al. (2014). “Dermatological spectrum of hand, foot and mouth disease from classical to generalized exanthema”. Pediatr Infect Dis J. 33 (4): e92–8. doi:10.1097/INF.0000000000000120. PMID 24463804.

[pmid13682692-1] ALSOP J, FLEWETT TH, FOSTER JR (1960). ““Hand-foot-and-mouth disease” in Birmingham in 1959″. Br Med J. 2 (5214): 1708–11. PMC 2098292. PMID 13682692.

[pmid25183845-2] Repass GL, Palmer WC, Stancampiano FF (2014). “Hand, foot, and mouth disease: identifying and managing an acute viral syndrome”. Cleve Clin J Med. 81 (9): 537–43. doi:10.3949/ccjm.81a.13132. PMID 25183845.

[pmid24463804-3] Hubiche T, Schuffenecker I, Boralevi F, Léauté-Labrèze C, Bornebusch L, Chiaverini C; et al. (2014). “Dermatological spectrum of hand, foot and mouth disease from classical to generalized exanthema”. Pediatr Infect Dis J. 33 (4): e92–8. doi:10.1097/INF.0000000000000120. PMID 24463804.

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