What is the recommended treatment for oral manifestations of Hand, Foot, and Mouth Disease (HFMD)?

From the Guidelines

The recommended treatment for oral manifestations of Hand, Foot, and Mouth Disease (HFMD) is primarily supportive and symptomatic, focusing on pain management and maintaining hydration. The treatment approach should prioritize alleviating symptoms to improve the patient's quality of life, as HFMD is a self-limiting condition. Key considerations include:

• Topical oral anesthetics such as viscous lidocaine 2% or over-the-counter benzocaine preparations for temporary pain relief 1.
• Oral rinses with salt water or a mixture of liquid diphenhydramine and liquid antacid to soothe painful ulcers.
• Acetaminophen or ibuprofen to manage pain and fever, with dosages of 10-15 mg/kg every 4-6 hours for acetaminophen and 5-10 mg/kg every 6-8 hours for ibuprofen.
• Maintaining adequate hydration through cold liquids, popsicles, and soft, bland foods, while avoiding spicy, acidic, or hot foods and beverages that may irritate the oral lesions. Since the provided evidence does not directly address the treatment of HFMD, the recommendations are based on general medical knowledge and the principle of prioritizing symptom management and patient comfort in the context of a self-limiting viral infection.

From the Research

Oral Appearance with HFMD

The oral manifestations of Hand, Foot, and Mouth Disease (HFMD) typically include painful oral ulcerations and lesions on the oral mucosa.

• The lesions usually resolve in seven to 10 days without complications 2.
• Oral ulcers are a common symptom of HFMD, often accompanied by fever and skin manifestations on the hands, feet, and buttocks 3.
• The mainstay of treatment for HFMD remains supportive care, with a focus on hydration and pain relief as needed with acetaminophen or ibuprofen 4, 2.

Treatment for Oral Manifestations

There is no specific pharmaceutical intervention for HFMD, and treatment is primarily focused on managing symptoms.

• Supportive care, including hydration and pain relief, is the standard of care for HFMD 4, 2.
• Antiviral treatment is not available for HFMD 2.
• Oral lidocaine is not recommended for treating oral ulcers in HFMD 2.

Prevention and Management

Preventing the spread of HFMD is crucial in managing the disease.

• Handwashing and disinfecting potentially contaminated surfaces and fomites are the best methods to prevent the spread of HFMD 2.
• Developing a vaccine strategy could help curb epidemics of HFMD, particularly with the emergence of new etiologies such as coxsackievirus A6 and coxsackievirus A10 5.