title: Coxsackievirus A6 Polymorphic Exanthem in Israeli Children.
abstract: Hand foot and mouth disease (HFMD) is an acute childhood viral exanthem usually associated with coxsackievirus A16 or enterovirus 71. Atypical HFMD associated with coxsackievirus A6 was reported recently. The aim of the current study was to describe coxsackievirus A6-associated atypical HFMD in a series of 8 toddlers who were referred with idiopathic extensive eruptions. Demographic and clinical characteristics, Reverse transcriptase-real-time PCR (RT-PCR) results for enterovirus and phylogenetic analysis for the coxsackievirus A6 strains were recorded. Morphologically polymorphous (vesicular, erosive, papular, desquamative or purpuric) and extensive eruptions were found. One patient had delayed nail shedding. Enterovirus was positive in all patients. Genotype analysis confirmed coxsackievirus A6 in 6 patients and 5 sequences underwent phylogenetic analysis. This is the first such report in Israeli children. In conclusion, coxsackievirus A6 atypical HFMD should be regarded as a novel childhood viral exanthem. We suggest the term "coxsackievirus A6 polymorphic exanthem" due to the extensive and variable nature of this eruption.
authors.affiliation: Department of Dermatology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel.
authors.forename: Yael
authors.initials: Y
authors.lastname: Renert-Yuval
authors.forename: Eytan
authors.initials: E
authors.lastname: Marva
authors.forename: Merav
authors.initials: M
authors.lastname: Weil
authors.forename: Lester M
authors.initials: LM
authors.lastname: Shulman
authors.forename: Nilsu
authors.initials: N
authors.lastname: Gencylmaz
authors.forename: Sivan
authors.initials: S
authors.lastname: Sheffer
authors.forename: Dana G
authors.initials: DG
authors.lastname: Wolf
authors.forename: Vered
authors.initials: V
authors.lastname: Molho-Pessach
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000998:Antiviral Agents / Q000627:therapeutic use; D002675:Child, Preschool; D004279:DNA, Viral / Q000235:genetics; D004770:Enterovirus / Q000235:genetics / Q000472:pathogenicity*; D005076:Exanthema / Q000175:diagnosis / Q000628:therapy / Q000821:virology*; D005260:Female; D005838:Genotype; D006232:Hand, Foot and Mouth Disease / Q000175:diagnosis / Q000628:therapy / Q000821:virology*; D006801:Humans; D007223:Infant; D007557:Israel; D008297:Male; D010802:Phylogeny; D016896:Treatment Outcome
chemical_list: D000305:Adrenal Cortex Hormones; D000900:Anti-Bacterial Agents; D000998:Antiviral Agents; D004279:DNA, Viral