title: Different patterns of skin manifestations associated with parvovirus B19 primary infection in adults.
abstract: BACKGROUND
  Skin involvement is reported during primary parvovirus B19 infection in adults.
  
  
  OBJECTIVE
  We sought to describe the cutaneous presentations associated with parvovirus B19 primary infection in adults.
  
  
  METHODS
  We conducted a descriptive, retrospective, multicenter study. The patients included (>18 years old) had well-established primary infections with parvovirus B19.
  
  
  RESULTS
  Twenty-nine patients were identified between 1992 and 2013 (17 women, 12 men). The elementary dermatologic lesions were mostly erythematous (86%) and often purpuric (69%). Pruritus was reported in 48% of cases. The rash predominated on the legs (93%), trunk (55%), and arms (45%), with a lower frequency of facial involvement (20%). Four different but sometimes overlapping patterns were identified (45%): exanthema, which was reticulated and annular in some cases (80%); the gloves-and-socks pattern (24%); the periflexural pattern (28%); and palpable purpura (24%).
  
  
  CONCLUSIONS
  The limitations of this study were its retrospective design and possible recruitment bias in tertiary care centers.
  
  
  CONCLUSIONS
  Our findings suggest that primary parvovirus B19 infection is associated with polymorphous skin manifestations with 4 predominant, sometimes overlapping, patterns. The acral or periflexural distribution of the rash and the presence of purpuric or annular/reticulate lesions are highly suggestive of parvovirus B19 infection.
authors.affiliation: Service de Dermatologie, Hôpital Cochin, Assistance Publique des Hôpitaux de Paris (APHP), et Université René Descartes, Paris, France.
authors.forename: Valentia
authors.initials: V
authors.lastname: Mage
authors.affiliation: Faculté de Médecine, Université de Strasbourg et Service de Dermatologie, Centre Hospitalier Régional Universitaire (CHRU), Strasbourg, France.
authors.forename: Dan
authors.initials: D
authors.lastname: Lipsker
authors.affiliation: Service de Dermatologie, Centre Hospitalo-Universitaire (CHU) de Nantes, Nantes, France.
authors.forename: Sébastien
authors.initials: S
authors.lastname: Barbarot
authors.affiliation: Service de Dermatologie, CHU de Montpellier, Montpellier, France.
authors.forename: Didier
authors.initials: D
authors.lastname: Bessis
authors.affiliation: Service de Dermatologie, Hôpital Henri Mondor, APHP et Université Paris-Est Créteil (UPEC), Créteil, France.
authors.forename: Olivier
authors.initials: O
authors.lastname: Chosidow
authors.affiliation: Service de Dermatologie, Centre Hospitalier (CH) de Fréjus, Fréjus, France.
authors.forename: Pascal
authors.initials: P
authors.lastname: Del Giudice
authors.affiliation: Service de Dermatologie, Hôpital Cochin, Assistance Publique des Hôpitaux de Paris (APHP), et Université René Descartes, Paris, France.
authors.forename: Sélim
authors.initials: S
authors.lastname: Aractingi
authors.affiliation: Service de Rhumatologie, Hôpital Cochin, APHP, et Université Paris Descartes, Paris, France.
authors.forename: Jérôme
authors.initials: J
authors.lastname: Avouac
authors.affiliation: Service de Dermatologie, Centre Hospitalo-Universitaire (CHU) de Nantes, Nantes, France.
authors.forename: Claire
authors.initials: C
authors.lastname: Bernier
authors.affiliation: Service de Dermatologie, Hôpital Bichat Claude Bernard, Paris, France.
authors.forename: Vincent
authors.initials: V
authors.lastname: Descamps
authors.affiliation: Service de Dermatologie, Hôpital Cochin, Assistance Publique des Hôpitaux de Paris (APHP), et Université René Descartes, Paris, France. Electronic address: nicolas.dupin@cch.aphp.fr.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Dupin
mesh_terms: D000328:Adult; D016731:Erythema Infectiosum / Q000473:pathology; D005076:Exanthema / Q000473:pathology / Q000821:virology*; D005260:Female; D006801:Humans; D008297:Male; D010322:Parvoviridae Infections / Q000473:pathology*; D016732:Parvovirus B19, Human; D012189:Retrospective Studies; D012867:Skin / Q000473:pathology*; D017193:Skin Diseases, Viral / Q000473:pathology*
keywords: exanthema; gloves and socks; infection; parvovirus B19; pruritus; purpura; virus