Atypical Hand, Foot, and Mouth Disease in an Immunocompetent Adult

Figures

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  Figure 1. Erythematous, red-brown football-shaped papules and vesicles - some with hemorrhagic crust - on palmar surfaces of bilateral hands at presentation.

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  Figure 2. Widespread, polymorphic erythematous, red-brown macules, papules, vesicles - some with hemorrhagic crust - on the trunk, groin, and lower extremities at presentation.

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  Figure 3. Massive superficial dermal edema, along with a perivascular, periadnexal, and interstitial mixed infiltrate (A: H&E, 20x magnification & B: H&E, 200x magnification).

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  Figure 4. Crust and necrosis limited to the upper epidermis with marked spongiosis including vesiculation with neutrophils (A: H&E, 40x magnification & B: H&E, 200x magnification).

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  Figure 5. Scattered polymorphous red-brown or hemorrhagic tense vesicles on palmar surfaces of bilateral hands with proximal desquamation at the wrists on hospital day 4.

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  Figure 6. Coalescing scattered polymorphous red-brown or hemorrhagic tense vesicles and macules of the bilateral lower extremities on hospital day 4.

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  Figure 7. Scattered polymorphous red-brown or hemorrhagic tense vesicles and macules on plantar surfaces and toes of bilateral feet with desquamation on hospital day 4.

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  Figure 8. Oral mucosa and posterior oropharynx without visible lesions on hospital day 4.