Previously, the most common form of HFMD was palmoplantar pharyngeal pale or dark red papules, macular rash and blisters surrounded by a red halo, in which the hand and foot blisters were thick-walled and not easily broken, and scattered red papules and blisters were occasionally seen around the anus, elbows and knees. Last year, the phenomenon of nail loss in HFMD began to be noticed, generally in children with fever and rash for one month after the disease, with complete or incomplete loss of fingernails. This year, the hand, foot and mouth disease rash is more extensive, more blisters, while the blisters are thin-walled and easy to break, also generally first fever, followed by ulcers of blisters in the oropharynx, pharynx dense, oral scattered (easy to be treated as herpes pharyngitis diagnosis), followed by two or three days of skin rash, extremities, buttocks most common, more blisters, larger, but also often fused into loose blisters, hand and foot rash is less and mild, blood tests can be seen leukocytes The total number of white blood cells is increased, the ratio of neutrophils to monocytes is increased, CRP is increased, and nail loss is still common one month after the disease. In previous years, it was more common in nursery children, but this year it is also more common in children living in the diaspora, and the age of onset is younger, some even a few months, so it is more contagious (the last picture is of twins), if this phenomenon is only seen in the Qinhuangdao area, perhaps it is related to the hot and humid summer, but of course, we cannot exclude that there are new or mutated viruses causing the disease. The good news is that children generally have mild systemic symptoms and can be cured successfully with simple treatment and active care.