The lesions last 5-10 days on the hands and feet. The mucosal and cutaneous lesions heal spontaneously in 5-7 days. The vesicles are rarely seen as they rapidly ulcerate. They are painful and may interfere with eating. The total number of ulcers averages 5-10 with palate, buccal mucosa, gingiva and tongue involvement.
Cutaneous lesions are characteristic and are present in two-thirds of patients.
Typical involvement occurs on the hands, feet and buttocks with the hands being involved more often than the feet, and the dorsal aspect of the hands and sides of the fingers more commonly involved than the palmar surfaces. Each lesion begins as a 2-10 mm erythematous macule upon which a central gray oval vesicle develops. The lesions characteristically have an elliptical shape with the long axis paralleling the skin lines. These lesions are asypmtomatic and resolve by fluid resorption in 3-7 days. Erythematous maculopapular eruptions may also occur on the buttocks and arms.