Eczema coxsackium B34.1

Extensive viral exanthema similar to eczema herpeticatum caused by an infection with coxsackieviruses of types A16 (CV-A16) and A6 (CV-A6) in patients with atopic dermatitis.

Hand-foot-and-mouth disease (HFMD) is caused by various serotypes of the enterovirus genus. Coxsackievirus A16 (CV-A16) and enterovirus A71 (EV-A71) were previously thought to be the only pathogens responsible for this viral infection. However, this was corrected after Coxsackievirus A6 (CV-A6) was found to be the responsible species for an endemic outbreak of this disease in Finland in 2008. CV-A6 was also identified as the pathogen in a Turkish study (Ceylan AN et al. 2019).

Patients initially present with a vesiculobullous, symmetrical exanthema. In the majority of patients, the exanthema affects > 10 % of the body surface. This is not only distributed in the classic areas of hand-foot-mouth disease such as palms, soles and buttocks, but also periorally, on the extremities and on the trunk. Other morphologies included Gianotti-Crosti-like (37%), petechial/purpuric (17%) changes and coarse lamellar desquamation on the palms of the hands and soles of the feet.

Serious systemic complications are not to be expected.

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2. Ganguly S et al (2016) Eczema Coxsackium. Indian J Dermatol 61: 682-683.
3. Lott JP et al. (2013) Atypical hand-foot-and-mouth disease associated with coxsackievirus A6 infection. J Am Acad Dermatol 69:736-741
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