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Dermatologic Manifestations of Enteroviral Infections Treatment & Management

  • Author: Mercè Alsina-Gibert, MD; Chief Editor: Dirk M Elston, MD  more...
Updated: Jul 12, 2016

Medical Care

Enteroviral infections in immunocompetent individuals heal spontaneously within 7-10 days; therefore, the main goal of treatment is symptomatic relief.

Neonates show a wide spectrum of signs and symptoms, which range from a nonspecific febrile illness to potentially fatal multisystem disease.[2]


Adequate hydration and antipyretics, such as acetaminophen, are helpful.


Some anecdotal evidence suggests that prophylactic immunoglobulin can mitigate disease severity in some exposed neonates. Immunoglobulin has also been used for the treatment of symptomatic infants with enterovirus infection.[2]


This is another antiviral drug that has demonstrated efficacy against enteroviruses. It is a broad-spectrum antiviral drug that blocks enteroviral attachment to cellular receptors.[38, 39, 40] Pleconaril therapy is prescribed for the treatment of severe neonatal enteroviral sepsis.[41]

Pyridyl imidazolidinone

A novel class of capsid binder, pyridyl imidazolidinone can inhibit enterovirus 71.[1]


Development of an inactivated enterovirus vaccine[42] and an inactivated whole-virus–based bivalent vaccine for both enterovirus 71 and coxsackie A virus 16 is in progress.[43]

Oral lesions

Mouth rinses with topical anesthetics (eg, lidocaine 2%) or antihistamines (eg, diphenhydramine hydrochloride) may relieve oral pain.[44]

Acyclovir was used in an open clinical trial involving 13 patients with hand-foot-and-mouth disease (HFMD). Involution of oral lesions occurred within 24 hours of the start of therapy. The mechanism of action was unknown; to the authors’ knowledge, no other series results have been published.

Allopurinol mouthwashes (3 mg/mL) are reported to accelerate the resolution of oral lesions.[45]

Contributor Information and Disclosures

Mercè Alsina-Gibert, MD Consultant, Department of Dermatology, Hospital Clinic, Spain

Disclosure: Nothing to disclose.


Steven Brett Sloan, MD Associate Professor, Department of Dermatology, University of Connecticut School of Medicine; Residency Site Director, Connecticut Veterans Affairs Healthcare System; Assistant Clinical Professor, Yale University School of Medicine

Steven Brett Sloan, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, Connecticut State Medical Society

Disclosure: Serve(d) as a director, officer, partner, employee, advisor, consultant or trustee for: Journal of the American Academy of Dermatology;Up to Date;Medical Review Institute of America.

Specialty Editor Board

David F Butler, MD Section Chief of Dermatology, Central Texas Veterans Healthcare System; Professor of Dermatology, Texas A&M University College of Medicine; Founding Chair, Department of Dermatology, Scott and White Clinic

David F Butler, MD is a member of the following medical societies: American Medical Association, Alpha Omega Alpha, Association of Military Dermatologists, American Academy of Dermatology, American Society for Dermatologic Surgery, American Society for MOHS Surgery, Phi Beta Kappa

Disclosure: Nothing to disclose.

Lester F Libow, MD Dermatopathologist, South Texas Dermatopathology Laboratory

Lester F Libow, MD is a member of the following medical societies: American Academy of Dermatology, American Society of Dermatopathology, Texas Medical Association

Disclosure: Nothing to disclose.

Chief Editor

Dirk M Elston, MD Professor and Chairman, Department of Dermatology and Dermatologic Surgery, Medical University of South Carolina College of Medicine

Dirk M Elston, MD is a member of the following medical societies: American Academy of Dermatology

Disclosure: Nothing to disclose.


Chad S Hendrickson, MD Resident Physician, Department of Dermatology, San Antonio Uniformed Services Health Education Consortium

Disclosure: Nothing to disclose.

Alex Llambrich-Mañes, MD Resident Physician, Department of Dermatology, University of Barcelona, Spain

Disclosure: Nothing to disclose.

Susanna Nogués-Siuraneta, MD Resident Physician, Department of Dermatology, Hospital Clinic de Barcelona

Disclosure: Nothing to disclose.

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Erosions on the base of the tongue.
A red halo surrounds several vesicles on the finger flexures and palms.
Small linear vesicle on the thumb.
Vesicle on the dorsal hand of a young adult.
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