Introduction:

Onychomadesis is the detachment of the nail plate from the proximal crease of the nail. This self-limited nail change has been described as a late complication of hand-foot-and-mouth disease, a common viral infection in children.

Case description:

A 4-year-old female child, accompanied by her father (legal representative), presented to an urgent appointment with high fever, vesicles, and pustules on the oral mucosa, tongue, perineum, palms, and soles of the hands and feet. The diagnosis of hand-foot-mouth disease was made. After three weeks, she returned to another appointment, with complete resolution of the viral picture, but with nail changes consistent with onychomadesis.

Comment:

Onychomadesis secondary to hand-foot-and-mouth disease is a relatively uncommon manifestation, but one that causes considerable anxiety to parents. Recognition of this association makes it possible to guide parents on the transient and benign situation that can arise with this viral infection, avoiding anxiety, overuse of health care, and unnecessary treatments.

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