title: Erythema infectiosum following generalized petechial eruption induced by human parvovirus B19.
abstract: Parvovirus B19 is a DNA virus responsible for a wide spectrum of clinical illnesses. Among dermatological manifestations, the most common is erythema infectiosum, also known as the fifth disease. In 1990 Harms et al first described a papular-purpuric gloves and socks syndrome (PPGSS) due to parvovirus B19. It is an acute acral dermatosis characterized by an eruption of petechiae and small purpuric papules affecting the hands and feet in a gloves-and-socks distribution. Recently it was observed that PPGSS may be associated with involvement of the peri-oral region and the chin (acropetechial syndrome) and other sites provoking unusual presentation of the rash. We describe a patient with an acral purpura with the features of the "acropetechial syndrome" involving the buttocks, genital and axillary regions who subsequently developed a maculopapular eruption with the characteristics of the fifth disease. Parvovirus B19 DNA was detected by polymerase chain reaction (PCR) both in skin vasculitic lesions and in the serum during the petechial eruption, before the onset of antibodies. The immune response coincided with the development of the exanthem, suggesting a direct role of parvovirus B19 in the pathogenesis of endothelial cell injury.
authors.affiliation: Unit of Dermatology, Department of Internal Medicine, Immunology and Infectious Diseases, University of Bari Policlinico, Bari, Italy. c.foti@dermatologia.uniba.it
authors.forename: Caterina
authors.initials: C
authors.lastname: Foti
authors.forename: Domenico
authors.initials: D
authors.lastname: Bonamonte
authors.forename: Anna
authors.initials: A
authors.lastname: Conserva
authors.forename: Mauro
authors.initials: M
authors.lastname: Grandolfo
authors.forename: Claudia
authors.initials: C
authors.lastname: Casulli
authors.forename: Baldassarre
authors.initials: B
authors.lastname: Martire
mesh_terms: D000328:Adult; D000914:Antibodies, Viral / Q000097:blood; D004279:DNA, Viral / Q000097:blood / Q000737:chemistry / Q000235:genetics; D016731:Erythema Infectiosum / Q000473:pathology* / Q000821:virology*; D006801:Humans; D008297:Male; D010322:Parvoviridae Infections / Q000473:pathology* / Q000821:virology; D016732:Parvovirus B19, Human / Q000235:genetics / Q000254:growth & development*; D016133:Polymerase Chain Reaction; D014766:Viremia / Q000473:pathology / Q000821:virology
chemical_list: D000914:Antibodies, Viral; D004279:DNA, Viral