Introduction:

Onychomadesis refers to the proximal separation of the nail plate from the matrix following a temporary arrest in nail formation, leading to nail shedding. While it can be a consequence of multiple aetiologies, it is uncommon in childhood. To our knowledge, this is the first case reporting the association between onychomadesis and hand-foot-and-mouth disease in the context of primary health care in Portugal.

Case description:

A previously healthy 21-month-old male child, otherwise asymptomatic except for fingernail alterations, was diagnosed with hand-foot-and-mouth disease four weeks before nail changes.

Comment:

Beau’s lines and onychomadesis are late complications of hand-foot-and-mouth disease. Clinicians must invest in a proper and detailed patients’ medical history and assess recent viral infections. On the other hand, the knowledge of probable indicators and of the association between onychomadesis and hand-foot-and-mouth disease itself may avoid inadequate investigations, referrals, and treatments. Furthermore, advising, and reassuring patients/parents/caregivers about possible nail alterations weeks following hand-foot-and-mouth disease may also prevent unnecessary concerns.

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