Atypical Hand, Foot, and Mouth Disease in an Immunocompetent Adult.

Hand, foot, and mouth disease (HFMD) is a common viral illness of childhood but is increasingly recognized in adults with often atypical and severe presentations. We report a case of HFMD in an immunocompetent man in his sixties who presented with a generalized, tender vesiculopapular eruption involving the groin, trunk, extremities, palms, and soles. An extensive infectious evaluation was initially pursued, and empiric broad-spectrum antimicrobials were administered. Dermatology consultation led to the diagnosis of HFMD, and antibiotics were discontinued with subsequent clinical improvement. This case highlights the importance of considering HFMD in the differential diagnosis of vesiculopapular eruptions in adults, particularly when the palms and soles are involved, to avoid unnecessary antimicrobial exposure and invasive testing.