Atypical yet real: hand, foot, and mouth disease beyond childhood– A rare adult case report

• Author Details:   
• Ranjeeta Mehta
• Sushma Darnal
• Jyotsna Seth
• Karpagavalli Shanmugasundaram3
• Shivani Kapurwan ^*

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Background: Hand, foot, and mouth disease (HFMD) is a self-limiting viral exanthem primarily seen in children under the age of five, commonly caused by Coxsackievirus A16 and Enterovirus A71. Its manifestation in adults is rare and frequently misdiagnosed due to atypical and protean clinical features.

Objective: To report uncommon presentation of HFMD in an immunocompetent adult, highlighting the importance of diagnostic acumen in non-paediatric populations.

Case Presentation: A 31-year-old female presented with painful vesiculoulcerative lesions on the tongue, labial frenum, buccal mucosa, palms, fingers, and plantar aspects of feet, suggestive of an underlying viral etiology.

Management and Outcome: The patient was managed with oral Valacyclovir, topical Acyclovir, Benzydamine mouthwash, Paracetamol, and multivitamin supplement.

Conclusion: This case underscores the necessity of including HFMD in the differential diagnosis of adult patients presenting with oral and acral lesions. Recognising its atypical presentation in adults is critical for accurate diagnosis, effective containment, and timely management.