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Hand-foot-and-mouth disease

Definition
HFMD is a common viral illness caused by enteroviruses, primarily affecting infants and children, although it can occasionally occur in adults.
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Pathophysiology
HFMD is caused by enteroviruses, most commonly Coxsackievirus A16 and Enterovirus 71. It transmitted through direct contact with the saliva, nasal mucus, blister fluid, and feces of infected individuals.
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Epidemiology
The incidence of HFMD in China is estimated at 197 per 100,000 person-years. HFMD shows seasonal variation, with a peak in cases typically occurring in spring and early summer, and possesses the potential to escalate to epidemic levels.
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Disease course
The clinical manifestations of HFMD typically include fever, sore throat, and a characteristic skin rash that presents as small, red, painful papules progressing to blisters on the hands, feet, and sometimes in the mouth, which can subsequently develop into ulcers.
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Prognosis and risk of recurrence
The disease course is generally self-limiting, with symptoms resolving within a week without specific treatment. However, in rare cases, severe cardiac and neurologic complications can occur.
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Key sources
The following summarized guidelines for the evaluation and management of hand-foot-and-mouth disease are prepared by our editorial team based on guidelines from the American Academy of Family Physicians (AAFP 2019).
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Guidelines

1.Screening and diagnosis

Diagnosis: diagnose HFMD based on the presence of a maculopapular or papulovesicular rash on the hands and soles of the feet and painful oral ulcerations.
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2.Medical management

Supportive care: provide supportive care to patients with HFMD. Consider offering weight-based acetaminophen or ibuprofen for the management of fever and pain. Do not use oral lidocaine.
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3.Preventative measures

Hand hygiene: advise proper handwashing to decrease the risk of transmitting HFMD.
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