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Hand Foot and Mouth Disease, Onychomadesis

Onicomadese e febre aftosa

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As though we do not hear enough about vírus causing problems in our lives, now we get to deal with another one!

Hand, Foot & Mouth Disease (HFMD) in our young children is more prevalent at this time of year.
HFMD is caused by a virus from the Coxsackievirus family (typically the A16 variant, but it can be caused by other strains), and it is highly contagious.
A diagnosis can be made by your Medical Doctor by the presenting signs and symptoms, or by doing a culture from a throat swab or a stool specimen. Traces can be found in the stool for up to 6 weeks after the infection, by which time the young placas de pregos will already be showing signs of onicomadese.

Onychomadesis is a shedding of the nails, beginning at the prega ungueal proximal, and is possibly caused by the temporary arrest of the function of the nail matriz. This causes the células da lâmina ungueal to be released all at once when the fever dies down a little.
We see it often in children that have had HFMD. It generally resolves without complication.

It is imperative to keep the nails clean – soap and water are your friends here – followed by a good quality oil.
A nail wrap (finger elastic tape?) comes into its own in this! We can cut it to fit those mini nails and toenails, and remove it at the end of the day without causing any problems. We can repeat it up to the moment when we can trim the nail off easily.
Nail wrap sticks to itself and not to the damaged nail plate – perfect for kids (and some adults) because we can cut it to size, and it fits just fine in little socks and shoes.

If the loose nail plate is causing a problem, file it lightly with a sponge file, and in a few weeks (about 6), cut it off.
The new one was already forming and should appear from underneath – but do not cut it too soon.

***Please refrain from using mechanical arquivos on a child’s nails or toenails, as it could cause severe damage.

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