When viewing this topic in a different language, you may notice some differences in the way the content is structured, but it still reflects the latest evidence-based guidance.

Last reviewed: 21 Mar 2025
Last updated: 11 Aug 2023

Summary

Definition

History and exam

Key diagnostic factors

  • presence of risk factors
  • low-grade fever
  • oral vesicles and ulcers
  • rash and/or vesicles on the hands and feet

Other diagnostic factors

  • malaise
  • sore mouth
  • loss of appetite
  • sore throat
  • rash and/or vesicles on the buttocks
  • abdominal pain
  • diarrhoea
  • cough
  • tongue erythema/oedema
  • arthralgia

Risk factors

  • immunosuppression
  • age <10 years
  • family or school contacts with infection

Diagnostic investigations

Treatment algorithm

Contributors

Authors

Malobi I. Ogboli, MBBS, FRCP

Consultant Dermatologist

Birmingham Children's Hospital and Birmingham City Hospital

Birmingham

UK

Disclosures

MIO declares that she has no competing interests.

Peer reviewers

Helen Goodyear, MBChB, MRCP, FRCPCH, MD, MMed

Consultant Paediatrician

Heartlands Hospital

Birmingham

UK

Disclosures

HG declares that she has no competing interests.

Andrew Riordan, MD, FRCPCH, MRCP, DTM&H

Consultant in Paediatric Infectious Diseases and Immunology

Royal Liverpool Children's Hospital (Alder Hey)

Liverpool

UK

Disclosures

AR declares that he has no competing interests.

David Cassarino, MD, PhD

Assistant Professor

Department of Pathology and Laboratory Medicine

University of California

Los Angeles

CA

Disclosures

DC declares that he has no competing interests.

Leonid Izikson, MD

Staff Dermatologist

Department of Dermatology

Massachusetts General Hospital

Boston

MA

Disclosures

LI declares that he has no competing interests.

Aisha Sethi, MD

Assistant Professor of Medicine

Associate Residency Program Director

University of Chicago

Chicago

IL

Disclosures

AS declares that she has no competing interests.

Use of this content is subject to our disclaimer