Renert-Yuval Yael, Marva Eytan, Weil Merav, Shulman Lester M, Gencylmaz Nilsu, Sheffer Sivan, Wolf Dana G, Molho-Pessach Vered
Department of Dermatology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel.
Acta Derm Venereol. 2016 May;96(4):546-9. doi: 10.2340/00015555-2261.
Hand foot and mouth disease (HFMD) is an acute childhood viral exanthem usually associated with coxsackievirus A16 or enterovirus 71. Atypical HFMD associated with coxsackievirus A6 was reported recently. The aim of the current study was to describe coxsackievirus A6-associated atypical HFMD in a series of 8 toddlers who were referred with idiopathic extensive eruptions. Demographic and clinical characteristics, Reverse transcriptase-real-time PCR (RT-PCR) results for enterovirus and phylogenetic analysis for the coxsackievirus A6 strains were recorded. Morphologically polymorphous (vesicular, erosive, papular, desquamative or purpuric) and extensive eruptions were found. One patient had delayed nail shedding. Enterovirus was positive in all patients. Genotype analysis confirmed coxsackievirus A6 in 6 patients and 5 sequences underwent phylogenetic analysis. This is the first such report in Israeli children. In conclusion, coxsackievirus A6 atypical HFMD should be regarded as a novel childhood viral exanthem. We suggest the term "coxsackievirus A6 polymorphic exanthem" due to the extensive and variable nature of this eruption.
手足口病（HFMD）是一种急性儿童病毒性疹病，通常与柯萨奇病毒A16或肠道病毒71型有关。最近有报道称出现了与柯萨奇病毒A6相关的非典型手足口病。本研究的目的是描述8名因特发性广泛皮疹前来就诊的幼儿中与柯萨奇病毒A6相关的非典型手足口病情况。记录了人口统计学和临床特征、肠道病毒的逆转录酶实时聚合酶链反应（RT-PCR）结果以及柯萨奇病毒A6毒株的系统发育分析结果。发现皮疹形态多样（水疱性、糜烂性、丘疹性、脱屑性或紫癜性）且广泛。1例患者指甲脱落延迟。所有患者肠道病毒检测均为阳性。基因型分析在6例患者中确认了柯萨奇病毒A6，对其中5个序列进行了系统发育分析。这是以色列儿童中的首例此类报告。总之，柯萨奇病毒A6非典型手足口病应被视为一种新型儿童病毒性疹病。鉴于这种皮疹广泛且多变的性质，我们建议使用“柯萨奇病毒A6多形性疹病”这一术语。
