Privileged localisation: Atypical hand–foot–mouth disease at locus minoris resistentiae.

This article focuses on atypical presentations of hand, foot, and mouth disease (HFMD) localized to previously healed burn scars in children, illustrating the concept of locus minoris resistentiae—areas of reduced resistance due to immune dysregulation following trauma. HFMD, caused primarily by Coxsackievirus A16 and Enterovirus 71, typically affects children under 10 with vesicular lesions on the hands, feet, and oral mucosa, but can present atypically with diverse morphologies and distributions. Two pediatric cases demonstrated classic HFMD lesions alongside unusual involvement of healed scald burn areas, supporting the idea that immune alterations in scarred skin predispose these sites to infection. Diagnosis is mainly clinical, and treatment is supportive, with most cases resolving within a week. The report emphasizes the need for awareness of such atypical presentations, especially in endemic regions.