Erythema, and sometimes painful brawny oedema of the palms and soles, often occurs in the acute phase.  Desquamation of the fingers and toes usually begins in the periungual region between 10-21 days after the onset of fever and may extend to involve the palms and soles.

Figure 13 Erythematous and oedematous palms11
Figure 14 Bilateral maculopapular erythethemous rash on dorsum of feet11
Figure 15 Desquamation of the fingers in the periungual region12

The absence of skin peeling does not exclude Kawasaki disease.