Case 187. Hand-foot-and-mouth disease (1 y-o F)
         
    Multiple vesicular lesions on the oral cavity, hip and extremities (biopsy from the leg skin)    
         
   
Key words : Coxackie virus A16, hand-foot-and-mouth disease
   
     
 
     
Spongiotic vesicles are formed in the epidermis. Exocytosis of lymphocytes is evident (HE). No viral inclusions are observed.   Closer view of the intraepidermal spongiotic vesicles (HE, higher power). Hand-foot-and-mouth disease is caused by infection of Coxsackie virus A19 or enterovirus 71. In the latter case, encephalitic complication is problematic. Refer to case 115.