Revista da Sociedade Portuguesa de Dermatologia e Venereologia (Oct 2024)
Hand, foot, and mouth disease with exuberant presentation in an adult: case report
Abstract
The following report describes a case of hand, foot, and mouth disease (HFMD) in an adult patient, presenting atypical manifestations due to its clinical exuberance. The patient, a 26-year-old physician, reported the onset of fever and odynophagia followed on the 2nd day by vesicles and enanthema on the soft palate, associated with erythematous papules in the perioral and nasal dorsum regions, extending to the hands and feet. The lesions progressed in severity and number over the days, exhibiting unusual characteristics. Onychomadesis also manifested in the nails after the 6th week. The diagnostic investigation included a series of serologies, highlighting reactivity to Coxsackievirus. A biopsy of a papulovesicular lesion revealed the presence of keratinocyte necrosis and inflammatory reaction in the dermis. The discussion encompasses the pathogenesis of HFMD, its atypical manifestations in adults, and the importance of diagnostic elucidation. This case report contributes to understanding the clinical variations of HFMD in adults, emphasizing the need to consider this entity even outside the predominant age group.
