Pediatric Eczema and Hand-Foot-Mouth Disease in a 9-Year-Old Male | Village Dermatology Katy & Houston, TX
By: Dr. Ashley Baldree
Introduction
Chronic skin irritation and viral rashes are common dermatologic concerns in children. Eczema (atopic dermatitis) and hand-foot-mouth disease (HFMD) may sometimes appear concurrently, particularly in pediatric patients with sensitive skin. This case describes a 9-year-old male who presented to Village Dermatology in Katy and Houston, Texas, with a chronic dry rash on his hands and arms, as well as recent vesicular lesions consistent with HFMD.
Patient Presentation
A 9-year-old male presented for evaluation of a painful, dry rash affecting the hands and arms for approximately two years.
The rash was lighter than the surrounding skin, itchy, and worsened during cold, dry weather.
Recently, he also developed small vesicles and erosions on both palms.
No prior prescription treatments had been used—only over-the-counter moisturizers.
Examination
A focused dermatologic exam included the hands, wrists, and feet.
Findings included:
Hypopigmented, dry patches on the dorsal hands and wrists, consistent with eczema.
Vesicular and erosive lesions on the right and left ulnar palms, consistent with hand-foot-mouth disease.
The rest of the exam was unremarkable.
The patient appeared well developed, alert, and in no acute distress.
Diagnosis
Dermatitis, Unspecified (L30.9) – consistent with eczema flare related to environmental triggers.
Hand-Foot-Mouth Disease (B08.4) – viral vesicular eruption of the hands and feet.
Management Plan
1. Eczema
The likely diagnosis of eczema was discussed in detail with the patient’s mother, including the chronic nature of the condition and environmental factors such as cold, dry air and frequent hand washing.
Treatment Plan:
Topical tacrolimus 0.1% ointment, applied twice daily to affected areas.
Continue liberal use of emollients 2–3 times daily, particularly after bathing.
Avoid scented soaps, detergents, and fabric softeners.
Recommended lukewarm bathing and use of gentle cleansers.
Discussed use of KattaMD resources for eczema-friendly nutrition and lifestyle guidance.
Counseling:
Reviewed the side effects and proper use of topical steroids and non-steroidal alternatives like tacrolimus.
Advised follow-up in 3 months to assess progress.
2. Hand-Foot-Mouth Disease
Findings: Vesicles and erosions on both palms.
Plan:
Explained that HFMD is a self-limited viral infection that typically resolves within 7–10 days.
Recommended supportive care, including topical anesthetics for any painful lesions.
Advised good hand hygiene and avoidance of close contact with others until lesions crust over.
Discussion
This case illustrates the overlap of chronic eczema and acute viral infection in a pediatric patient. Children with eczema are prone to increased skin sensitivity and may experience flares triggered by viral illnesses or environmental factors. Management focuses on restoring the skin barrier, controlling inflammation, and preventing secondary infections.
Conclusion
At Village Dermatology in Katy and Houston, TX, pediatric patients with chronic rashes receive comprehensive evaluation and care. This case highlights the importance of identifying both chronic conditions like eczema and acute viral infections such as hand-foot-mouth disease, and providing gentle, evidence-based treatment tailored to each child’s needs.
