What is the sequence of rash development in hand, foot, and mouth disease?

　　The typical sequence of rash development in hand, foot, and mouth disease usually begins with lesions on the oral mucosa, followed by gradual appearance on the palms and soles. The rash may later spread to the buttocks, perianal area, and proximal limbs. Although the order may vary slightly among some patients, this general pattern is commonly observed. If the rash becomes dense, accompanied by persistent high fever or lethargy, prompt medical attention is recommended.

　　Oral mucosal rashes typically first appear on the tongue, buccal mucosa, and hard palate. They initially present as red maculopapular eruptions, rapidly progressing to small vesicles or ulcers. Pain associated with these lesions often leads to refusal of food and drooling in affected children, which are common early signs of hand, foot, and mouth disease.

　　One to two days after the onset of oral lesions, scattered or clustered maculopapular rashes appear on the palms and soles, evolving into vesicles. These vesicles have thick walls and are less likely to rupture, possibly causing mild itching or pain. In the buttocks and perianal regions, rashes often consist of both red maculopapules and vesicles coexisting, relatively dispersed in distribution, with milder symptoms.

　　For care, maintain good oral hygiene in the child; rinsing with lukewarm saline water can help relieve pain. Dress the child in loose, soft clothing to minimize friction on the rash areas, and keep the skin clean and dry. Provide a diet consisting mainly of liquids or semi-liquids, avoid spicy or irritating foods, and encourage ample fluid intake to maintain hydration.