Coxsackievirus A16 caused hand-foot-mouth disease in a young male: A case report

Hand–foot–and–mouth disease (HFMD) is typically a pediatric illness, yet adults may be affected and overlooked. We report an immunocompetent 24-year-old man with a 3-day prodrome of fever, myalgia, sore throat, and headache, followed by intensely pruritic palmoplantar lesions with sparse oral disease. Examination revealed numerous 2–4 mm painless erythematous macules and papules on the palms, fewer on the soles and peri-oral skin, and a single tender soft-palate ulcer. Differential diagnoses included herpes simplex, varicella zoster, erythema multiforme, secondary syphilis, drug eruption, and scabies. Stool polymerase chain reaction confirmed Coxsackievirus A16. Supportive care consisted of antihistamines, non-steroidal anti-inflammatory drugs, topical calamine–zinc oxide, and oral hyaluronic acid gel. Pruritus resolved by day 2; mucocutaneous lesions regressed without complications and were nearly resolved with palmar desquamation by day 9. This case highlights an adult, pruritus-predominant, minimally vesicular phenotype with scant oral involvement and no childcare exposure. Clinicians should consider HFMD in adults with palmoplantar eruptions and emphasize symptomatic management and hygiene counseling to limit transmission.