Clinical Pearl Wednesday #112

Infant Announcement Birth Boy Girl  - viarami / Pixabay

Have a pediatric patient with small erythematous blisters in the diaper region? Be sure to examine the mouth, hands, and feet as well.

Hand-foot-mouth disease in children can also present with a diaper rash. Sometimes the patient’s parents will be concerned because the child will be running a fever, have a lower appetite, and have a concerning rash in the diaper area but fail to examine their mouth or palms of hands and/or feet.

I have seen dozens of pediatric patients over the past decade who have a diaper rash with hand-foot-mouth disease. Sometimes, the patient might only have the rash in the mouth, hands, and diaper area but no rash on the feet or any mix of the rash locations. It is important to know this as it will help guide you to an accurate diagnosis. So, be sure to examine the diaper area if you suspect hand-foot-mouth disease. Luckily it is self-limiting and does not require any specific treatment, but knowing that the diaper area can be involved will help confirm your diagnosis.

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