Boston disease is sometimes confused with chickenpox, both of which develop a rash. But Boston's disease is caused by a different virus, and the symptoms - especially the location of the rash - are different. The Boston virus attacks children most often, but adults also get sick sometimes. Learn how to recognize Boston Disease and the treatment of Boston Disease.

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Boston Disease( Boston ), also known asBoston rash , is caused by Coxsackie viruses with enterovirus families - these are most often Coxsackie A5, A9, A10, A16, B1, and B3 viruses and enterovirus 71 (EV 71). Some people wrongly say that the Boston virus is responsible for the development of the disease.

Boston infection occurs throughcontact with secretionsa sick person or asymptomatic carrier ("dirty hands disease"), but it is important that the viruses are excreted in the faeces even for several weeks after the symptoms have resolved. Due to the high contagiousness, epidemic infections are sometimes encountered in nurseries, kindergartens and other centers.

To describe this disease, specialists also usenames :

  • enteroviral stomatitis with rash
  • vesicular rash, which is a disease of the hand, foot and mouth
  • eczema vesicular vesicular stomatitis
  • enteroviral rash fever
  • hand, foot and mouth disease (HFM)

Professional literature does not use the name Boston disease, nor is it covered by the ICD-10 International Classification of Diseases.

Boston disease is most common in children aged2 to 10 years , but Boston is also diagnosed inadults¹. While in children it is mild, and the recovery takes place in about7-10 daysand the disease does not have any consequences, its course in adults can be more burdensome and long-lasting, with possible systemic cardiac or neurological complications. Such complications rarely occur in children. Cases of encephalomyelitis and acute myocarditis have been reported sporadically.

Boston disease: rash and other symptoms

The main symptoms of Boston Disease are:

  • fever (also referred to as Boston fever)
  • sore throat
  • general malaise
  • rash
  • they are sometimes accompanied by a lack of appetite, nausea, vomiting and diarrhea
  • cervical lymphadenopathy

Rashin Boston Disease:

  • is in the form of serous blisters 1-3 mm in diameter, similar to that of chickenpox
  • occurs only on the hands and feet, as well as in the mouth and throat - they occupy the back wall of the throat, soft palate, tongue, gums and cheek mucosa
  • sometimes it also happens that a papular rash also appears on the skin of other parts of the body, e.g. on the buttocks or trunk
  • bubbles, especially those in the mouth, are very bothersome. They break easily, resulting in sharply delineated erosions on a red surface, often painful, which make it difficult to eat or drink anything

Then, very characteristic oblong (oval or elliptical) bubbles appear on the skingray bubbleswith a thin cover of 3-7 mm, set on a vivid red / cherry substrate. The lesions are most often located on the palms, soles of the feet, and the side surfaces of the hands and feet, but spots and blisters may also appear on the buttocks and genital area; they are very rare on the face, limbs and torso.

Boston Disease: Diagnostics

Your doctor should distinguish Boston Disease from other conditions that show up as a rash. First of all, from chicken pox - in this case, the lesions are scattered over the skin of the trunk, limbs, face and even within the hairy scalp. The distribution of changes resembles a sky dotted with stars.

The doctor should also distinguish the Boston disease from allergies - here there is intense itching and the presence of scattered lesions on the skin of the whole body.

Another common diagnosis is erythema multiforme exudative (minor variety) in the course of herpes simplex - here the skin eruptions are usually larger and have the shape of a shooting target .¹

Boston Disease: Treatment

The disease, like many other viral diseases, requires symptomatic treatment.antipyretic and analgesic agents are given.

Rash bubbles should be dried, as with smallpox, with anti-viral lotions and creams or gentian violet, which can be purchased at a pharmacy. It is important that the patient does not scratch or squeeze the contents of the blisters as this may lead to secondary bacterial infections. It is indicated in some cases to prevent itching and burningthe inclusion of antihistamines. We avoid powders because they favor bacterial superinfections. The disease is mild in most cases. Complications in the form of meningitis are very rare.

Importantly, traveling over Bostondoes not protectagainst falling ill again.

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Coxsackie viruses: the cause of many diseases

Coxsackie viruses that cause Boston Disease are also responsible for the common cold, pharyngitis and viral angina, and lukewarm diarrhea in infants. They can also cause serious diseases: myocarditis and pancreatitis.

There is a theory that it is the infection with Coxsackie viruses that connects type 1 diabetes. According to it, it is these viruses that destroy the pancreatic island cells responsible for the production of insulin.

Bibliography:

1. Kuchciak-Brancewicz M., Bienias W., Kaszuba A.,Boston disease , "Practical Dermatology" 2014, No. 1

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