Dermatologic Manifestations of Hand-Foot-and-Mouth Disease Medication
- Author: Brad S Graham, MD; Chief Editor: Dirk M Elston, MD more...
The topical application of anesthetics is beneficial. Viscous lidocaine, dyclonine solution, or diphenhydramine (Benadryl) may be used to treat painful oral ulcers. Antipyretics may be used to manage fever, and analgesics may be used to treat arthralgias.
A case report of severe hand-foot-and-mouth disease (HFMD) from enterovirus infection in an immunocompromised patient described a faster resolution of symptoms and lesions with oral acyclovir. Low-level laser therapy has also been shown to shorten the duration of painful oral ulcers.
Anesthetic agents, topical
These agents provide symptomatic relief of pain as a result of mucosal lesions.
Dyclonine is a topical anesthetic available in a solution, spray, or lozenge. It affects cell membrane permeability and blocks impulses at peripheral nerve endings in the skin.
Viscous lidocaine (Dilocaine; DermaFlex Gel)
Viscous lidocaine is a topical anesthetic. It decreases permeability to sodium ions in neuronal membranes and results in inhibition of depolarization, blocking the transmission of nerve impulses.
Antihistamines act by means of the competitive inhibition of histamine at the H1 receptor. This effect mediates wheal and flare reactions, bronchial constriction, mucous secretion, smooth muscle contraction, edema, hypotension, CNS depression, and cardiac arrhythmias.
Diphenhydramine is in the ethanolamine class, a histamine receptor type 1 blocker. It has significant anticholinergic and sedative properties that causes some degree of topical anesthesia by impairing the transmission of nerve impulses.
These agents are used for the symptomatic treatment of acid-induced gastritis and the treatment of GI ulcers.
Sucralfate is an aluminum complex antacid that may help in the treatment of oral mucosal ulcerations. Similar to its effects on GI ulcers, sucralfate forms a viscous adhesive substance that protects the GI lining against pepsin, peptic acid, and bile salts. It binds and covers the ulcer, promoting healing.
The combination of aluminum hydroxide, magnesium hydroxide, and simethicone lowers gastric pH and covers ulcer bases. Similar to its effect on GI ulcers, it may cover the ulcer base, allowing more rapid healing. Magnesium and/or aluminum antacid mixtures are used to prevent bowel function changes.
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