What is the relationship between herpes pharyngitis and hand, foot and mouth disease?

Herpes pharyngitis and HFMD share part of the same causative agent and have similar epidemic seasons and clinical symptoms, so they are often easily confused with each other.
According to the 2018 edition of the Guidelines for the Treatment of Hand, Foot, and Mouth Disease.
In the epidemic season of HFMD, when a rash has not yet appeared on the hands, feet and buttocks in the early stages of herpes pharyngitis in children, attention needs to be paid to communication with parents and observation of the rash on the hands, feet and buttocks; if a rash on the hands, feet and buttocks is never seen, it can be treated as herpes pharyngitis and a diagnosis of HFMD is not appropriate; and
once a typical herpes on the hands, feet and buttocks is found, it should be treated according to HFMD.
For severe cases with an atypical rash, the diagnosis needs to be made in conjunction with pathogenesis or serum antibodies.

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