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3yo with fever and rash

Coxsackie virus A6 has been associated with outbreaks of a more severe variant of hand-foot-mouth disease, with larger bullae, and more widespread lesions involving the trunk and limbs. At times, it may be mistaken for disseminated herpes. It is also associated with onychomadesis (shedding of nails) approximately 1-2 months after illness. More information on Coxsackie A6 here. Additional FOAM resources on hand foot mouth disease in general at emin5.com and WikEM