Parvovirus in dermatology: A review

Abstract Parvovirus B19 is a small nonenveloped single‐stranded DNA virus belonging to the parvoviridae family. The dermatological manifestations are varied ranging from infective to inflammatory, but the most common among infective etiologies is erythema infectiosum, also known as the fifth disease or ‘slapped cheek’ disease, which is mildly contagious. Clinical corroboration of symptoms and signs with serum antibody levels has been seen in acute and persistent parvoviral infections. Other dermatological manifestations of parvovirus B19 infections include erythema multiforme, vasculitis, reticular erythema, maculopapular eruptions, pustular eruptions, papular‐purpuric gloves and socks syndrome (PPGSS) and Gianotti‐Crosti syndrome. Skin lesions are quite characteristic and begin with oedema and erythema symmetrically localized to the hands and feet. Subsequently, petechial and purpuric changes appear varying from a few millimetres in diameter to larger, confluent patches. The primary target of parvovirus B19 is the hematopoietic‐erythroid cell line, specifically near the pronormoblast stage and the vulnerability to cellular damage increases along the differentiation lineage. There's multimodal clinical phenotypic presentation seen in parvoviral infections. Among the clinical expression of HPV B19 infections, the most common is dermatologic, however other manifestations such as rheumatologic and hematologic are not uncommon. However, some infections can be asymptomatic, especially in immunocompetent hosts, whereas in others with haematological abnormalities, these can lead to aplastic cellular crises.