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PP-062 Onychomadesis post viral exanthema in children
  1. Esmeralda Skuka1,
  2. Anila Rexha1,
  3. Esmeralda Meta2
  1. 1Clinical Centre Nr 1, Tirana, Albania
  2. 2Infectious Diseases Clinic, University Hospital Centre ‘Mother Theresa, Tirana, Albania


Aim The aim of our case-study is to identify rare complications on nails after viral rash as in ‘Hand Foot and Mouth Disease’. HFMD is most common viral infection related with coxsackieviruses, echoviruses and enteroviruses. It’s self limited, but not rare are seen complication as Onychomadesis appeared 6–8 weeks later. Onychomadesis interrupts the growth of the nails for one to two weeks, leading to the breakout of the nail plate from her bed.

Material and Method Case report: Our case refered 16 month old boy, who came to Clinic Centre Nr 1 on June 2023 with fever 38 C degree on three days, on the third day vesicular lesions appered in and around the mouth, the puddle of the hand and gluteal muscles. The child was healthy, without others health problems. The treatment recomanded consist on NSAIDs and acetaminopine ;the healing process lasted about 10 days. In that period of time, in our country, variant 16 of coxsackieviruses was identified as the cause of HFMD. In the ending of 1st week on Agust 2023 he cames again. His nails were breakdown in different stage and parents refered that the process begun same days before (figure 1). We perfomed the blood exames: WBC-6560 mm3, Neutrophils-1.570 cell/mm3, Lymphocyte 4,190 cell/mm3, RBC-4.940 000 cell/mm3, Hb-10,4 g/dl, PLT – 414100 cell/mm3, VES-12mm/h, Ferritin-4.334ng/ml, Vitamin D3 –32.22ng/ml, Calcemia-9.8mg/dl. Nail culture tests meanwhile revealed mold in the child’s nails.

Abstract PP-062 Figure 1

Onychomadesis on hand nails. Hand nails of 16 month old child. Compmlicated with onychomadesis after six weeks of HFMD.

Results We didnt use other medication. Through follow up every week, we noticed that haling began and in end of mouth all nails were cured.

Conclusions Conditions that can cause onychomadesis include several predisposing factors. The mechanism of onychomadesis after HFMD is not fully understood. However, viral infection is responsible for onychomadesis, as a temporal latency exists between HFMD and onychomadesis. Follow-up is important to catch long-term complications in time, and their adequate evaluation.

  • Onychomadesis
  • HFMD
  • Children

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