From the Guidelines
Yes, hand, foot, and mouth disease (HFMD) can cause nail changes in toddlers, specifically onychomadesis (nail shedding), as reported in a 2018 study published in the Journal of Clinical Virology 1. The most common nail changes associated with HFMD include:
- Nail shedding (onychomadesis)
- Potential for other nail changes, although less commonly reported These nail changes are temporary and usually resolve on their own without treatment, as the nail grows out. The nail changes occur because HFMD, particularly CV-A6, affects the nail matrix, the area where nail growth begins, as evidenced by the recovery of the virus from fingernail in HFMD cases 1. No specific treatment is needed for these nail changes. However, parents should:
- Keep the child's nails clean and trimmed
- Avoid picking or manipulating the affected nails
- Monitor for any signs of secondary infection, such as redness, swelling, or pus If parents are concerned or if there are signs of infection, they should consult their pediatrician for further evaluation and guidance. It is essential to note that the viral load in vesicle fluid is usually high, and typing might be helpful in identifying the specific virus responsible for the infection, such as CV-A6, which has been associated with onychomadesis 1.
From the Research
Nail Changes in Toddlers with Hand, Foot, and Mouth Disease
- Hand, Foot, and Mouth Disease (HFMD) can cause nail changes in toddlers, including onychomadesis and Beau's lines 2, 3, 4, 5.
- Onychomadesis is a condition where the nail separates from the nail bed, while Beau's lines are transverse lines that appear on the nails 2.
- These nail changes typically occur 1-2 months after the onset of HFMD and can last for several weeks 3, 4, 5.
- The exact mechanism of nail changes in HFMD is not fully understood, but it is thought to be related to the viral infection causing an inflammatory response that affects nail growth 2, 4.
- Nail changes associated with HFMD are usually self-limiting and resolve on their own without treatment 3, 4, 5.
- Fingernails are more commonly affected than toenails, and the changes can occur synchronously on multiple nails 4.
- Awareness of the potential for nail changes after HFMD can help prevent unnecessary diagnostic and invasive interventions 5, 6.