These lesions may be asymptomatic or pruritic. They usually begin as erythematous macules that rapidly progress to thick-walled, grey vesicles with an erythematous base. In young infants, these lesions may also be seen on the trunk, thighs and buttocks. If clinical circumstances dictate, the virus can be recovered from the HFM lesions. Typically, the virus can be grown in culture or confirmed by immunologic methods.
Treatment is primarily supportive.
It is extremely important to examine the patient's hydration status by evaluation and documentation of lacrimation, mucosal membranes, skin turgor, urine output and pulse or capillary refill time. Antipyretics should be given, as needed, for fever. IV hydration should be given if the clinical patient assessment indicates. Antibiotics are not indicated unless there is a complicating secondary skin infection. There are a number of potential remedies for the pain associated with the oral lesions that may cause the child to decrease oral intake.