Isla Bennett
Hand, foot, and mouth disease (HFMD) is a contagious viral infection that commonly affects children under the age of 10 but has also been reported in adults. It is characterised by painful mouth sores, blisters, and a rash on the hands and feet. In rare cases, individuals may experience nail abnormalities or even complete nail loss following an episode of HFMD. This condition, known as onychomadesis, typically occurs 4 to 8 weeks after the initial onset of the disease and is characterised by nail shedding, Beau lines, and discolouration. While this complication usually resolves on its own, it can be a distressing experience for those affected.
| Characteristics | Values |
|---|---|
| How common is nail loss? | Very rare |
| Who does it affect? | Most reports are in children, but adults can also be affected |
| How long after contracting hand, foot, and mouth disease does nail loss occur? | 4-8 weeks after the onset of the disease |
| How long does it take for nails to regrow? | 6 to 18 months |
| Does it require treatment? | No, it is usually self-limited and does not require treatment |
| What do nails look like before falling off? | Nails may develop grey, white, or greenish-yellow patches that spread towards the free edge |
| Are there any other nail abnormalities associated with hand, foot, and mouth disease? | Yes, leukonychia, Beau lines, and yellowish-orange discolouration of the nail plate |
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What You'll Learn
- Nail shedding is a rare complication of hand, foot, and mouth disease
- Beau lines, leukonychia, and nail discolouration are common abnormalities
- Nail changes tend to resolve within 1-2 months without intervention
- Nail shedding occurs 4-8 weeks after disease onset
- HFMD is a mild, contagious viral infection caused by coxsackieviruses
Nail shedding is a rare complication of hand, foot, and mouth disease
Hand, foot, and mouth disease (HFMD) is a contagious viral infection that commonly affects children under the age of 10 but has also been reported in adults. It is primarily caused by coxsackieviruses, particularly coxsackievirus A16 and, in some cases, Human enterovirus 71. The disease typically presents with fever, rashes, and sores or blisters on the hands, feet, mouth, and buttocks.
While nail shedding is an uncommon complication of HFMD, it has been observed in a small percentage of cases. This condition, known as onychomadesis, involves the partial or complete shedding of nails from the proximal nail beds. It usually occurs 4 to 6 weeks after the initial onset of the disease and is often self-limited, requiring no specific treatment. In some instances, nail changes may appear as grey, white, or greenish-yellowish patches on the nails, which then spread towards the free edge, resulting in nail shedding.
Several case reports have described nail shedding in individuals, particularly children, following HFMD. For example, a 9-month-old boy presented to the emergency department with rapidly progressing nail changes on all four extremities a few days after recovering from HFMD. Similarly, a 7-year-old boy with a history of eczema experienced painful peeling of his fingernails several days after recovering from HFMD. In another case, an adult reported nail shedding and bubbling on their fingernails and toenails after contracting HFMD from their toddler.
The exact mechanism of onychomadesis following HFMD is not fully understood. However, it is believed to be associated with temporary inhibition of nail matrix activity due to direct inflammation from periungual HFMD lesions, viral proliferation in the nail matrix, or the systemic effects of the disease. Nail shedding typically resolves within 1 to 2 months, and the nail plate usually grows out completely within 6 to 18 months.
While nail shedding after HFMD is uncommon, it is important to recognize this potential complication to provide reassurance and avoid unnecessary treatment. Most cases of nail shedding resolve spontaneously, and the nail gradually grows back over time.
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Beau lines, leukonychia, and nail discolouration are common abnormalities
Hand, foot, and mouth disease (HFMD) is a contagious viral infection that affects children, although it has also been reported in adults. It is caused by a group of coxsackieviruses, primarily coxsackievirus A16 and human enterovirus 71. While the disease typically manifests as fever, rashes, and mouth sores, it can sometimes lead to nail abnormalities, including onychomadesis, Beau lines, leukonychia, and nail discolouration.
Onychomadesis is a rare complication of HFMD, characterised by partial or complete shedding of nails. It typically occurs four to six weeks after the illness onset and usually does not require any treatment. The nail shedding may be preceded by the appearance of grey, white, or greenish-yellow patches on the nails, which then spread towards the free edge of the nail. As the nails shed, new, thin pink nails slowly grow in their place.
Beau lines are horizontal grooves that run across the nail plates. They are often observed in individuals with HFMD and are associated with temporary disruptions in nail growth, such as those caused by illness or injury. These grooves can appear as indentations or raised ridges and may be accompanied by changes in nail colour or texture.
Leukonychia refers to white discolouration of the nails. It can manifest as white spots, streaks, or a cloudy appearance on the nail plate. Leukonychia can have various causes, including trauma, certain medications, and, in the context of HFMD, viral infections. While nail discolouration can be alarming, it is typically a harmless sign of previous or ongoing inflammation or infection.
Nail abnormalities associated with HFMD usually resolve within one to two months without any specific intervention. However, it is important to monitor for any signs of infection or other complications. In some cases, individuals may choose to use nail strengthening products or apply creams to alleviate discomfort and protect the nails during the healing process.
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Nail changes tend to resolve within 1-2 months without intervention
Hand-foot-and-mouth disease (HFMD) is a contagious viral infection that affects children and, occasionally, adults. It is typically caused by coxsackieviruses, specifically coxsackievirus A16 and Human enterovirus 71. The disease presents with symptoms such as fever, rashes on the hands, feet, and buttocks, and ulcers in the mouth. In severe cases, the rash spreads to the arms, legs, and face.
One possible complication of HFMD is onychomadesis, which is characterised by nail shedding and changes in nail colour. This occurs in only 4% of severe cases, usually 3 to 6 weeks after the initial infection. Nail changes can include leukonychia, Beau lines (horizontal grooves across the nail), and partial or complete nail shedding. These changes typically begin with a greenish-yellowish or grey-white patch appearing at the base of the nail and spreading towards the free edge. As the nails shed, new, thin pink nails slowly grow in their place.
While nail changes can be distressing, it is important to note that onychomadesis is usually a self-limited condition that does not require any specific treatment. In most cases, no intervention is necessary, as the nail changes tend to resolve spontaneously within 1 to 2 months. During this time, individuals may choose to use moisturising creams to soothe raw skin and nail strengthening products to minimise discomfort and protect the nails from catching on things. However, these are not medical necessities and more of a personal preference.
The exact mechanism behind onychomadesis in HFMD is not fully understood. It is believed that the condition may be caused by temporary inhibition of nail matrix proliferation due to periungual inflammatory reactions or the direct impact of enteroviruses on the nail matrix. This results in the nail bed lifting away from the nail plate, leading to nail shedding.
It is worth noting that nail abnormalities associated with HFMD are generally uncommon and tend to occur in only a small percentage of cases. Most often, HFMD is a mild and harmless illness that resolves without any long-term effects.
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Nail shedding occurs 4-8 weeks after disease onset
Hand, foot, and mouth disease (HFMD) is a contagious viral infection that affects children and, occasionally, adults. It is typically caused by coxsackieviruses, specifically coxsackievirus A16 and Human enterovirus 71. The disease is characterised by fever, rashes, and mouth ulcers.
In rare cases, HFMD can lead to nail abnormalities, including onychomadesis, a condition characterised by nail shedding. This complication usually occurs 4 to 8 weeks after the initial disease onset. It is believed that onychomadesis is caused by the temporary inhibition of nail matrix activity due to inflammation from periungual HFMD lesions, the proliferation of the virus in the nail matrix, or the systemic impact of the disease.
Several case reports describe individuals, both children and adults, who experienced nail shedding after recovering from HFMD. In one case, a 7-year-old boy with a history of eczema presented with painful peeling of his fingernails several days after recovering from HFMD. Initially, grey-white patches appeared on the bottom of his nails, which eventually led to complete nail shedding over the course of two weeks. Beau lines, or horizontal grooves, were also observed on the nail beds.
Another case involved a 9-month-old boy who presented to the emergency department with rapidly progressing nail changes after recovering from HFMD. Nail shedding began with a greenish-yellowish patch at the beginning of the nails, progressing towards the free edge. Simultaneously, fresh, thin pink nails began to grow. This process of nail shedding and regeneration typically occurs within 1 to 2 months, and no active intervention is usually required.
While nail shedding after HFMD is uncommon, it is important to recognise this potential complication to avoid unnecessary treatment and provide reassurance to patients and their families.
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HFMD is a mild, contagious viral infection caused by coxsackieviruses
Hand, foot and mouth disease (HFMD) is a contagious viral infection. It is usually mild and often affects young children. HFMD is caused by viruses, most commonly the coxsackievirus A16. It can also be caused by enterovirus 71, which is associated with more severe symptoms.
The illness is characterised by a blister-like rash on the hands and feet and painful sores in the mouth. Other symptoms include fever, itching, and general flu-like symptoms. In rare cases, a serious form of the enterovirus can affect the brain and cause complications such as viral meningitis and encephalitis.
HFMD is highly contagious and can spread through person-to-person contact with infected nose secretions or throat discharge, fluid from blisters, and droplets in the air from coughing or sneezing. It is most commonly spread among young children in childcare settings, as they frequently put their hands in their mouths and require diaper changes. The virus can also be spread by touching contaminated surfaces or objects, such as toys.
Good hygiene practices are essential to prevent the spread of HFMD. This includes frequent hand washing, disinfecting surfaces, and avoiding close contact with infected individuals. While there is no specific treatment for HFMD, the illness typically resolves within 7 to 10 days, and pain medication can be taken to manage symptoms.
In some cases, individuals may experience nail shedding or onychomadesis after recovering from HFMD. This occurs when a grey-white patch appears on the bottom of the nails, which then shed from the bottom to the free border of the nail. Fresh, thin pink nails then grow slowly in their place. Nail abnormalities can range from leukonychia and Beau lines (horizontal grooves) to partial or complete nail shedding. This complication typically occurs four to six weeks after the illness onset and usually resolves without treatment.
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Frequently asked questions
Hand, foot and mouth disease (HFMD) is a contagious viral infection caused by a group of coxsackieviruses, mainly coxsackievirus A16 and Human enterovirus 71. It is characterised by fever, rashes on the hands, feet, knees, buttocks and mouth.
Yes, onychomadesis is a rare, late complication of hand, foot and mouth disease. It is characterised by partial or complete nail shedding, Beau's lines and discolouration of the nail plate.
Nail abnormalities typically occur 4-8 weeks after the onset of the disease.
No intervention or follow-up is required as the nail will grow out along with the nail plate. This process can take 6 to 18 months.
