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Journal of the American Academy of Dermatology
Volume 71, n° 1
pages 62-69 (juillet 2014)
Doi : 10.1016/j.jaad.2014.02.044
accepted : 27 February 2014
Original Articles

Different patterns of skin manifestations associated with parvovirus B19 primary infection in adults
 

Valentia Mage, MD a, Dan Lipsker, MD, PhD b, Sébastien Barbarot, MD, PhD c, Didier Bessis, MD, PhD d, Olivier Chosidow, MD, PhD e, Pascal Del Giudice, MD f, Sélim Aractingi, MD, PhD a, Jérôme Avouac, MD g, Claire Bernier, MD c, Vincent Descamps, MD, PhD h, Nicolas Dupin, MD a,
a Service de Dermatologie, Hôpital Cochin, Assistance Publique des Hôpitaux de Paris (APHP), et Université René Descartes, Paris, France 
b Faculté de Médecine, Université de Strasbourg et Service de Dermatologie, Centre Hospitalier Régional Universitaire (CHRU), Strasbourg, France 
c Service de Dermatologie, Centre Hospitalo-Universitaire (CHU) de Nantes, Nantes, France 
d Service de Dermatologie, CHU de Montpellier, Montpellier, France 
e Service de Dermatologie, Hôpital Henri Mondor, APHP et Université Paris-Est Créteil (UPEC), Créteil, France 
f Service de Dermatologie, Centre Hospitalier (CH) de Fréjus, Fréjus, France 
g Service de Rhumatologie, Hôpital Cochin, APHP, et Université Paris Descartes, Paris, France 
h Service de Dermatologie, Hôpital Bichat Claude Bernard, Paris, France 

Reprint requests: Nicolas Dupin, MD, Service de Dermatologie, Hôpital Cochin, APHP, et Université René Descartes, Pavillon Tarnier, 89 rue d’Assas, 75006 Paris.
Abstract
Background

Skin involvement is reported during primary parvovirus B19 infection in adults.

Objectives

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%).

Limitations

The limitations of this study were its retrospective design and possible recruitment bias in tertiary care centers.

Conclusion

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.

The full text of this article is available in PDF format.

Key words : exanthema, gloves and socks, infection, parvovirus B19, pruritus, purpura, virus



 Funding sources: None.
 Conflicts of interest: None declared.



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