Valentia Mage1, Dan Lipsker2, Sébastien Barbarot3, Didier Bessis4, Olivier Chosidow5, Pascal Del Giudice6, Sélim Aractingi1, Jérôme Avouac7, Claire Bernier3, Vincent Descamps8, Nicolas Dupin9. 1. Service de Dermatologie, Hôpital Cochin, Assistance Publique des Hôpitaux de Paris (APHP), et Université René Descartes, Paris, France. 2. Faculté de Médecine, Université de Strasbourg et Service de Dermatologie, Centre Hospitalier Régional Universitaire (CHRU), Strasbourg, France. 3. Service de Dermatologie, Centre Hospitalo-Universitaire (CHU) de Nantes, Nantes, France. 4. Service de Dermatologie, CHU de Montpellier, Montpellier, France. 5. Service de Dermatologie, Hôpital Henri Mondor, APHP et Université Paris-Est Créteil (UPEC), Créteil, France. 6. Service de Dermatologie, Centre Hospitalier (CH) de Fréjus, Fréjus, France. 7. Service de Rhumatologie, Hôpital Cochin, APHP, et Université Paris Descartes, Paris, France. 8. Service de Dermatologie, Hôpital Bichat Claude Bernard, Paris, France. 9. 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.
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.
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.