Erythema Infectiosum (Fifth Disease) 

  • Author: Glenn L Zellman, MD; Chief Editor: Dirk M Elston, MD   more...
 
Updated: Jan 26, 2012
 

Background

Erythema infectiosum (fifth disease) is a common childhood exanthem caused by human parvovirus B19 (PV-B19), an erythrovirus, in which a classic 3-phased cutaneous eruption follows a rarely noticed prodrome.[1]

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Pathophysiology

The development of erythema infectiosum (fifth disease) in children is a normal response to infection by PV-B19. Acute infection in a host who is immunocompetent leads to a Th-1–mediated cellular immune response, with the production of specific immunoglobulin M (IgM) antibodies and subsequent formation of immune complexes. Clinical signs and symptoms of erythema infectiosum (fifth disease) probably result from the deposition of the immune complexes in the skin and joints of individuals with this condition and not from the circulating virus.

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Epidemiology

Frequency

International

Worldwide, epidemics of erythema infectiosum (fifth disease) tend to occur in the late winter or early spring, with cyclical peaks of incidence occurring every 4-7 years. Approximately 60% of adults are seropositive for PV-B19 by age 20 years. Infection rates vary from 20-50% in schools and households during outbreaks.[2, 3, 4]

Mortality/Morbidity

Erythema infectiosum (fifth disease) is a self-limited illness that resolves without complications or sequelae in its classic childhood form. Infection in adults, hosts who are immunocompromised, and patients who are anemic or pregnant can result in more significant morbidity.

Sex

Males and females are infected equally by erythema infectiosum (fifth disease). Arthropathy is more common in women. Women may be affected by complications from erythema infectiosum (fifth disease) during pregnancy.[5, 6]

Age

Erythema infectiosum (fifth disease) primarily is a disease of children aged 3-15 years, but it can occur at any age.[7] PV-B19 infection can lead to the classic symptoms of erythema infectiosum (fifth disease) in adults but more often manifests as an acute arthropathy without cutaneous eruption.

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Contributor Information and Disclosures
Author

Glenn L Zellman, MD  Consulting Staff, Department of Internal Medicine, University Hospital, Tamarac, Florida

Disclosure: Nothing to disclose.

Specialty Editor Board

Bernice R Krafchik, MBChB, FRCPC  Professor Emeritus, Department of Pediatrics, Section of Dermatology, University of Toronto

Bernice R Krafchik, MBChB, FRCPC is a member of the following medical societies: American Academy of Dermatology, American Dermatological Association, Canadian Medical Association, College of Physicians and Surgeons of Ontario, Royal College of Physicians and Surgeons of Canada, and Society for Pediatric Dermatology

Disclosure: Nothing to disclose.

Richard P Vinson, MD  Assistant Clinical Professor, Department of Dermatology, Texas Tech University Health Sciences Center, Paul L Foster School of Medicine; Consulting Staff, Mountain View Dermatology, PA

Richard P Vinson, MD is a member of the following medical societies: American Academy of Dermatology, Association of Military Dermatologists, Texas Dermatological Society, and Texas Medical Association

Disclosure: Nothing to disclose.

Van Perry, MD  Assistant Professor, Department of Medicine, Division of Dermatology, University of Texas School of Medicine at San Antonio

Van Perry, MD is a member of the following medical societies: American Academy of Dermatology and American Society for Laser Medicine and Surgery

Disclosure: Nothing to disclose.

Catherine M Quirk, MD  Clinical Assistant Professor, Department of Dermatology, University of Pennsylvania

Catherine M Quirk, MD is a member of the following medical societies: Alpha Omega Alpha and American Academy of Dermatology

Disclosure: Nothing to disclose.

Chief Editor

Dirk M Elston, MD  Director, Ackerman Academy of Dermatopathology, New York

Dirk M Elston, MD is a member of the following medical societies: American Academy of Dermatology

Disclosure: Nothing to disclose.

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Classic slapped-cheek appearance of fifth disease.
Pathognomonic reticulated lacy-appearing eruption of fifth disease.
 
 
 
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