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Hand-Foot-Mouth Syndrome

The information in NORD’s Rare Disease Database is for educational purposes only. It should never be used for diagnostic or treatment purposes. If you have questions regarding a medical condition, always seek the advice of your physician or other qualified health professional. NORD’s reports provide a brief overview of rare diseases. For more specific information, we encourage you to contact your personal physician or the agencies listed as “Resources” on this report.

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Synonyms of Hand-Foot-Mouth Syndrome

Disorder Subdivisions

General Discussion

Hand-Foot-Mouth syndrome is an infectious disease that, in most cases, is caused by the coxsackie virus A16. The disease most often occurs in young children and is characterized by a rash of small blister-like sores (lesions). The rash usually occurs on the palms of the hands, soles of the feet, and in the mouth.


Hand-Foot-Mouth syndrome is an infectious disease characterized by blister-like sores (lesions) that appear on the palms of the hands, soles of the feet and in the mouth. The lesions in the mouth most commonly affect the lining of the cheeks (buccal mucosa), tongue, lips, and hard palate. The lesions occasionally may appear on the buttocks, extremities or genitals. Lesions may group together and eventually ulcerate. Symptoms may also include a sore throat, headache, low-grade fever, vomiting, loss of appetite or refusal to eat due to the lesions in the mouth, especially those on the cheek and tongue. The symptoms of the disease last for about one week.

In most cases, the Hand-Foot-Mouth syndrome is not associated with serious complications. However, according to the medical literature, some cases of the disease caused by enterovirus 71 have been associated with the accumulation of fluid in the lungs (pulmonary edema) and neurological complications such as mild inflammation of the membranes (meninges) that surround the brain (aseptic meningitis).


The principal cause of Hand-Foot-Mouth syndrome is believed to be the coxsackie virus A16. However, some cases have been described that were caused by the coxsackie virus A4, A5, A7, A9, A10, B2, and B5 and by enterovirus 71.

Affected Populations

Hand-Foot-Mouth syndrome is affects males and females in equal numbers. The disease is most common in young children and is seen more frequently in the summer and fall. The disorder is contagious.

Related Disorders

Symptoms of the following disorders can be similar to those of Hand-Foot- Mouth Syndrome. Comparisons may be useful for a differential diagnosis:

The varicella-zoster virus is a herpes virus that causes chickenpox during childhood, and shingles (herpes zoster) during adulthood. It is characterized by a sore throat, runny nose, a general feeling of discomfort and a blister-like rash. (For more information on this disorder, choose "Varicella" as your search term in the Rare Disease Database.

Herpangina is a viral infection that usually affects infants and young children. It is characterized by a sore throat with fever, headache, loss of appetite, and pains in the abdomen, neck and extremities. Vomiting and convulsions may occur in infants. Within two days a small number (usually less than 12) of elevated pimple-like lesions appear on the tonsils, soft palate, uvula or tongue. These lesions eventually become shallow ulcers and will heal within 5 days.

Standard Therapies

The diagnosis of Hand-Foot-Mouth syndrome maybe confirmed by a thorough clinical evaluation and a detailed patient history. Several tests may be conducted to analyze the liquid portion of the blood (serum) to determine which type of virus is present in a particular cause of Hand-Foot-Mouth syndrome (serological tests).

There is no specific treatment for Hand-Foot-Mouth syndrome. Calamine lotion may have a soothing effect on the rash and acetaminophen (e.g., Tylenol), given every 4 hours, will help reduce the fever and headache. Aspirin should NOT be given to children with viral diseases, because it can cause Reye Syndrome. (For more information on this disorder, choose "Reye" as your search term in the Rare Disease Database.) Other treatment is symptomatic and supportive.

Investigational Therapies

According to the medical literature, some affected individuals have been treated with the anti-viral drug acyclovir. More studies are needed to determine the long-term safety and effectiveness of this drug for the treatment of Hand-Foot-Mouth Syndrome.

Information on current clinical trials is posted on the Internet at www.clinicaltrials.gov. All studies receiving U.S. Government funding, and some supported by private industry, are posted on this government web site.

For information about clinical trials being conducted at the NIH Clinical Center in Bethesda, MD, contact the NIH Patient Recruitment Office:

Tollfree: (800) 411-1222
TTY: (866) 411-1010
Email: prpl@cc.nih.gov

For information about clinical trials sponsored by private sources, contact:

Hand-Foot-Mouth Syndrome Resources



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Kushner D, et al., Hand-Foot-Mouth disease. J Am Podiatr Assoc. 1996:86:257-9.

Sala F, et al., Hand-Foot-Mouth disease: its course in the city of Milan (1980-86). Epidemiologic study gathered from the records of the community and scholastic ambulatory services of the istituto di clinica dermatologic I and dermatologia pediatrica of the university. G Ital Dermatol Venereol. 1989;124:63-6.

Gilbert G, et al., Outbreak of enterovirus 71 infection in Victoria, Australia, with a high incidence of neurological involvement. Pediatr Infect Dis J. 1988;7:484-8.



Report last updated: 2009/05/11 00:00:00 GMT+0