Hand foot and mouth disease.

with fever, malaise and asymptomatic oro-cutaneous lesions for the past 3-4 days, after being involved in cleaning activity of a fish pond. On examination he was febrile (temperature 100oF) with no lymphadenopathy. Oral cavity showed aphthae-like lesions having small yellowish-white shallow necrotic vesicles surrounded by red areola over palate, buccal and labial mucosae (Fig.1). Cutaneous lesions comprised multiple erythematous, 35mm, round/oval macules, and pearly-white vesicles with a red areola over palms and soles (Fig.2), dorsal aspect of fingers, buttocks and elbows. Systemic examination and investigative profile were essentially normal. A clinical diagnosis of hand, foot and mouth disease was made. The child was treated symptomatically.