Onychomadesis after hand-foot-and-mouth disease outbreak in northern Greece: Case series and brief review of the literature

Zoe Apalla, Eleni Sotiriou, Olga Pikou, Ioanna Lefaki, Aimilios Lallas, Elizabeth Lazaridou, Demetris Ioannides

Research output: Contribution to journalArticle

Abstract

Background: Nail abnormalities in childhood are generally uncommon. Recently, onychomadesis was described as a late complication of hand-foot-and-mouth disease (HFMD). Onychomadesis outbreaks following HFMD have been reported in many countries worldwide. Aim: To present a case series of onychomadesis in children, following HFMD outbreak in Northern Greece, and review literature data. Methods: Children with evident onychomadesis attending the outpatient clinic between November 2012 and January 2013 were included in the study. A questionnaire including demographic personal and family history information of the children was completed by the parents. Patients were clinically examined, and their pediatric and dermatological records were studied to confirm precedent HFMD. Direct microscopic examination and cultures for fungi were performed. Exposure of participants to coxsackievirus, based on serology testing during infection, was also recorded. Results: Sixty-eight children with onychomadesis were included. The mean number of affected nails was 8.82. Fingernails were more often involved. Previous clinical diagnosis of HFMD was confirmed in 67/68 cases. The mean time from HFMD diagnosis to onychomadesis development was 39.6 days (range: 28-56 days, STD: 7.33). Direct microscopic examination, as well as cultures for fungal species, was negative for the whole sample size. All the nail changes were transient with spontaneous regrowth after 1-4 months. Conclusion: Our data indicate that onychomadesis outbreak in the region of Thessaloniki during fall-winter 2012-13 was highly related to the outbreak of HFMD. Our study reinforces existing evidence for the association between onychomadesis and HFMD.

Original languageEnglish
Pages (from-to)1039-1044
Number of pages6
JournalInternational Journal of Dermatology
Volume54
Issue number9
DOIs
Publication statusPublished - Sep 1 2015

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Hand, Foot and Mouth Disease
Greece
Disease Outbreaks
Nails
Malformed Nails
Enterovirus
Serology
Sexually Transmitted Diseases
Ambulatory Care Facilities
Sample Size
Fungi
Parents
Demography
Pediatrics

ASJC Scopus subject areas

  • Dermatology

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Onychomadesis after hand-foot-and-mouth disease outbreak in northern Greece : Case series and brief review of the literature. / Apalla, Zoe; Sotiriou, Eleni; Pikou, Olga; Lefaki, Ioanna; Lallas, Aimilios; Lazaridou, Elizabeth; Ioannides, Demetris.

In: International Journal of Dermatology, Vol. 54, No. 9, 01.09.2015, p. 1039-1044.

Research output: Contribution to journalArticle

Apalla, Zoe ; Sotiriou, Eleni ; Pikou, Olga ; Lefaki, Ioanna ; Lallas, Aimilios ; Lazaridou, Elizabeth ; Ioannides, Demetris. / Onychomadesis after hand-foot-and-mouth disease outbreak in northern Greece : Case series and brief review of the literature. In: International Journal of Dermatology. 2015 ; Vol. 54, No. 9. pp. 1039-1044.
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