Nikhil Thatte
Medical Science Department, Pediatric Oncall, Mumbai


The main aim of treatment in HFMD is to reduce the severity and duration of symptoms. As such, there is no curative therapy. Hence, care is purely supportive. Topical antihistamines like diphenhydramine are useful to treat pruritis. NSAIDs (Ibuprofen, paracetamol) may be used for pain relief and control of fever. Aspirin is NOT to be used in children under 12 years of age as it carries the risk of precipitating Reye's syndrome. Antipyretics are given as and when required. Fluids should be given to maintain hydration. Since the oral ulcers are very pain sensitive, the child may refuse feeds. Juices and carbonated beverages are not recommended as they contain a significant acid content which causes pain. Hence, cold milk preparations like ice cream are ideal feeds.

		The main complication that can occur is a secondary skin infection
		Rarely, cardiopulmonary and CNS complications like cardiopulmonary failure, aseptic meningitis, etc. may occur. These are associated with outbreaks caused by Enterovirus 71.

Prognosis: Complete recovery is the norm in HFMD

	1.	Suzuki Y, Taya K, Nakashima K, et al. Study on Risk Factors for Severe Hand-foot-and- mouth Disease. Pediatr Int. Aug 3 2009
	2.	http://www.hindustantimes.com/rssfeed/mumbai/City-sees-rise-in-hand-foot-and- mouth-disease-in-kids/Article1-467035.aspx ;
	3.	http://timesofindia.indiatimes.com/city/vadodara/Hand-foot-and-mouth-disease-rears- its-head-in-city/articleshow/4846366.cms
	4.	Wolff K, Johnson RA, Suurmond D. Viral infections of skin and mucosa. In: Fitzpatrick's Color Atlas & Synopsis of Clinical Dermatology. 5th ed. New York, NY: McGraw-Hill; 2005:790-92.
	5.	http://emedicine.medscape.com/article/802260-overview
	6.	Tsao KC, Chang PY, Ning HC, et al. Use of molecular assay in diagnosis of hand, foot and mouth disease caused by enterovirus 71 or coxsackievirus A 16. J Virol Methods. Apr 2002;102(1-2):9-14.