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A 41-year-old man developed hand, foot and mouth disease caused during treatment with azathioprine and lost the nails of the digits 1 and 5 of both hands [route not stated].
The man presented with a 2-day history of a painful papulovesicular eruption on the hands and feet. He suffered from a fever, general malaise and a mild cough after which the lesions started appearing on the palmar site of the hands. Subsequently, the lesions appeared on the dorsal site of hands and fingers and on the feet extending to the calves within 48h. The symptoms started several hours after visiting a public swimming pool. He had Wegener's granulomatosis for which he was receiving azathioprine 150mg daily since 2011. Moreover, he used omeprazole and cotrimoxazole for years and started hydrochlorothiazide...