Characterizing Viral Exanthems

Joseph M Lam


Pediatr Health. 2010;4(6):623-635. 

In This Article

Conclusion & Future Perspective

Our understanding of certain viral exanthems has expanded significantly since the original description of the classic exanthems of childhood. Many viral diseases, such as measles, rubella and varicella, are now preventable with vaccination. However, our understanding and recognition of new viral-associated exanthems continues to expand. In the case of papular acrodermatitis of childhood, what was once thought to be a manifestation of hepatitis B is now recognized to be a manifestation of a number of infectious agents, including viruses. In the case of acute generalized exanthematous pustulosis, what was once thought to be a drug-induced exanthem is now recognized to have viral triggers. In the case of parvovirus B19, the ability to detect the virus in seronegative patients using PCR has been useful in linking the virus to erythema infectiousum, as well as other manifestations, such as PPGSS and generalized petechiae.

There are still cases of exanthematous disease where the roles of viruses have yet to be fully elucidated. These include the association of HHV-6 and -7 reactivation in drug hypersensitivity syndrome, the role of viral triggers in Kawasaki syndrome and the role of viruses in dermatological conditions with seasonal clustering, such as lichen striatus. Improving laboratory testing in combination with continual clinical sleuthing may provide clues to the role of viruses in these and other exathematous disease in childhood.


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