Coxsackievirus type A16, and occasionally types A4, A5, A9, and A10, are associated with hand, foot, and mouth disease. This entity is characterized by the development of a few small vesicles on the tongue, gingiva, soft palate, and buccal mucosa. These vesicles rupture, resulting in painful, shallow ulcers with a surrounding red halo. The lateral and dorsal aspects of the fingers and toes are frequently involved and aid the diagnosis. The buttocks, palms, and plantar surfaces of the feet may be affected. Fever is usually of short duration, and the disease lasts 5 to 8 days. Treatment is palliative. 11
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