Encyclopedia of Pathology

Living Edition
| Editors: J.H.J.M. van Krieken

Hand-Foot-and-Mouth Disease

Living reference work entry
DOI: https://doi.org/10.1007/978-3-319-28845-1_727-1



Hand-foot-and-mouth disease is an infection, caused by enterovirus (EV) or Coxsackievirus group A (CVA), most frequently CVA2, 4, 10, or 16 and EV71, just as herpangina, presenting with a skin rash and oral lesions associated with flu-like symptoms and occasionally cough, rhinorrhea, anorexia, vomiting, diarrhea, myalgia, and headache. Oral and hand lesions are almost always present, with the oral lesions preceding the cutaneous lesions.

In the oral region 1–30 rapidly ulcerating vesicular lesions, 2–7 mm in diameter are present. On the skin, usually a few to dozens of erythematous macules developing central vesicles can be found.

Hypothesis about the seasonal pattern of HA and HFMD include host immune competence fluctuations mediated by seasonal factors, such as melatonin or vitamin D levels; seasonal behavioral factors, such as school attendance and indoor crowding; environmental factors, such as temperature and relative...

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References and Further Reading

  1. Brown, B. A., Oberste, M. S., Alexander, J. P., Kennett, M. L., & Pallansch, M. A. (1999). Molecular epidemiology and evolution of Enterovirus 71 strains isolated from 1970 to 1998. Journal of Virology, 73, 9969–9975.PubMedPubMedCentralGoogle Scholar
  2. Buchner, A. (1976). Hand, foot, mouth disease. Oral Surgery, 41, 333–337.CrossRefGoogle Scholar
  3. Chang, P.-T., Chen, S.-C., & Chen, K.-T. (2016). The current status of disease caused by Enterovirus 71 infections: Epidemiology, pathogenesis, molecular epidemiology, and vaccine development. International Journal of Environmental Research and Public Health, 13, 890.CrossRefPubMedCentralGoogle Scholar
  4. Ho, M., Chen, E. R., Hsu, K. H., Twu, S. J., Chen, K. T., Tsai, S. F., Wang, J. R., & Shih, S. R. (1999). Taiwan Enterovirus Epidemic Working Group. New England Journal of Medicine, 341, 929–935.CrossRefPubMedGoogle Scholar
  5. McMinn, P. C. (2002). An overview of the evolution of Enterovirus 71 and its clinical and public health significance. FEMS Microbiology Reviews, 26, 91–107.CrossRefPubMedGoogle Scholar
  6. Rabenau, H. F., Richter, M., & Doerr, H. W. (2010). Hand, foot and mouth disease: Seroprevalence of Coxsackie A16 and Enterovirus 71 in Germany. Medical Microbiology and Immunology, 199, 45–51.CrossRefPubMedGoogle Scholar
  7. Tsao, K. C., Chang, P. Y., Ning, H. C., Sun, C. F., Lin, T. Y., Chang, L. Y., Huang, Y. C., & Shih, S. R. (2002). Use of molecular assay in diagnosis of hand, foot and mouth disease caused by Enterovirus 71 or Coxsackievirus A16. Journal of Virological Methods, 102, 9–14.CrossRefPubMedGoogle Scholar

Copyright information

© Springer International Publishing AG 2017

Authors and Affiliations

  1. 1.Department of PathologyAntoni van Leeuwenhoek Hospital, The Netherlands Cancer InstituteAmsterdamThe Netherlands