Joint diagnosis of pediatric and dermatology clinics: Prospective observation of thirtynine patients with hand, foot and mouth disease

Bucak, �brahim Hakan; Tepe, Birg�l; Almi�, Habip; K�se, Ahmet; Turgut, Mehmet

Joint diagnosis of pediatric and dermatology clinics: Prospective observation of thirtynine patients with hand, foot and mouth disease [Turkderm-Turk Arch Dermatol Venereol]

Turkderm-Turk Arch Dermatol Venereol. 2017; 51(2): 41-45 | DOI: 10.4274/turkderm.22804

Joint diagnosis of pediatric and dermatology clinics: Prospective observation of thirtynine patients with hand, foot and mouth disease

�brahim Hakan Bucak¹, Birg�l Tepe², Habip Almi�¹, Ahmet K�se¹, Mehmet Turgut¹
¹Ad�yaman University Faculty of Medicine, Department of Pediatrics, Ad�yaman, Turkey
²Ad�yaman University Faculty of Medicine, Department of Dermatology, Ad�yaman, Turkey

Background and Design: Hand, foot and mouth disease (HFMD) is a childhood enteroviral eruptive disease presenting with fever and
cutaneous and mucosal lesions. It is benign and generally resolves spontaneously, but may sometimes result in systemic involvement. The purpose of this study was to share our clinical experience concerning patients who were followed with the diagnosis of HFMD established by the pediatric and dermatology clinics.
Materials and Methods: We prospectively evaluated patients who attended our hospital with the complaints of fever and eruptions and
received the diagnosis of HFMD based on the clinical findings between December 2014 and November 2015. Age, sex, month of presentation, presentation symptoms and duration of symptoms were investigated. Systemic and dermatological examination findings, laboratory results and tests such as echocardiography were reviewed.
Results: Thirty-nine patients were included; 19 (48.8%) were girl and 20 (51.2%) were boy. The mean age of the patients was 29.8�27.9
(6-155) months. Six (15.3%) patients were in the 0-12 month age group, while only 3 (7.8%) were older than 60 months. Presentations were most common in September, June and October. The most common presentation symptoms were eruptions on the hands and feet (100%), fever (82.1%) and oral aphthae (79.5%). The lesions were most commonly observed on the hands (94.9%, n=37) and feet (87.2%, n=34) and in the mouth (79.5%, n=31). Cardiac involvement was determined in 3 (7.7%) patients. Nail changes were observed during monitoring in 10 (25.6%) patients.
Conclusion: Our results show that the age of onset of HFMD in Turkey has decreased compared to that reported in the previous studies.
Patients must be evaluated in detail in terms of clinical and laboratory findings showing severity of the disease. This study also shows that pediatricians/dermatologists collaboration is of great importance.

Keywords: Hand-foot-mouth disease, cardiac involvement, onychomadesis

Pediatri ve dermatoloji kliniklerinin ortak tan�s�: El-ayak-a��z hastal�� olan otuz dokuz hastan�n prospektif izlemi

�brahim Hakan Bucak¹, Birg�l Tepe², Habip Almi�¹, Ahmet K�se¹, Mehmet Turgut¹
¹Ad�yaman �niversitesi T�p Fak�ltesi, �ocuk Sa�l�� Ve Hastal�klar� Anabilim Dal�, Ad�yaman
²Ad�yaman �niversitesi T�p Fak�ltesi, Deri Ve Z�hrevi Hastal�klar Anabilim Dal�, Ad�yaman

Ama�: El-ayak-a��z hastal�� (EAAH); ate�, deri ve mukoza lezyonlar� ile seyreden, �ocukluk �a��n�n enteroviral d�k�nt�l� bir hastal��d�r. �yi seyirli ve kendili�inden d�zelme e�iliminde olmakla birlikte, nadiren sistemik tutuluma yol a�abilir. Bu �al��man�n amac�, pediatri ve dermatoloji klinikleri taraf�ndan EAAH tan�s�yla takip edilen hastalara ait klinik deneyimlerimizi payla�makt�r.
Gere� ve Y�ntem: Hastanemize Aral�k 2014-Kas�m 2015 tarihleri aras�nda ate� ve d�k�nt� �ikayeti ile ba�vuran hastalardan, klinik bulgulara dayan�larak EAAH tan�s� koyulan hastalar prospektif olarak de�erlendirildi. Hastalar�n ya��, cinsiyeti, ba�vuru ay�, ba�vuru �ikayeti ve s�resi sorguland�. Sistemik ve dermatolojik muayene bulgular�, laboratuvar sonu�lar�, ekokardiyografi gibi ek inceleme tetkikleri g�zden ge�irildi.
Bulgular: �al��maya toplam 39 hasta dahil edildi. Hastalar�n 19'u (%48,8) k�z, 20'si (%51,2) erkek idi. Hastalar�n ortalama ya�� 29,8�27,9 (6- 155) ay olarak hesapland�. Ya� aral��na g�re hastalar�n 6's� (%15,3) 0-12 ay aras�nda iken, sadece 3'� (%7,8) 60 aydan b�y�kt�. Ba�vurular en s�k Eyl�l, Haziran ve Ekim aylar�nda g�r�ld�. En s�k ba�vuru �ikayeti; el ve ayaklarda d�k�nt� (%100), ate� (%82,1) ve oral aft (%79,5) idi. Lezyonlar, en s�k el (%94,9, n=37), ayak (%87,2, n=34) ve a��z i�inde (%79,5, n=31) g�r�ld�. �� hastada (%7,7) kardiyak tutulum saptand�. Takiplerde 10 hastada (%25,6) t�rnak de�i�ikli�i geli�ti.
Sonu�: �al��mam�z sonucunda �lkemizde EAAH�nin g�r�lme ya��n�n �nceki yay�nlara nazaran k��ld�� tespit edildi. Hastalar�n hastal��n �iddetini g�steren klinik ve laboratuvar bulgular a��s�ndan ayr�nt�l� de�erlendirilmesi gereklidir.

Anahtar Kelimeler: El-ayak-a��z hastal��, kardiyak tutulum, onikomadezis

�brahim Hakan Bucak, Birg�l Tepe, Habip Almi�, Ahmet K�se, Mehmet Turgut. Joint diagnosis of pediatric and dermatology clinics: Prospective observation of thirtynine patients with hand, foot and mouth disease. Turkderm-Turk Arch Dermatol Venereol. 2017; 51(2): 41-45

Corresponding Author: �brahim Hakan Bucak, T�rkiye

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