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Background
This disease is often referred to as Fifth Disease because it is the fifth common childhood disease. The classic description of the patient is that of a slapped cheek. Patients usually have mild prodromal illness of respiratory symptoms and low grade fever. The slapped cheek rash appears first, predominately occurring on the cheeks and sparing the bridge of the nose and perioral area. When this eruption occurs, antibodies are formed. The rash becomes generalized and appears as lacy reticulated macules over the trunk and extremities, occurring as the facial rash fades. This generalized rash may flare with physical stimuli such as light, heat, or physical activity. In 15% of cases, it is pruritic. The majority of cases resolve within 1-2 weeks but occasional cases may last for 6 weeks.
It was only recently that the agent of infection has been identified as the parvovirus B19. This virus has been associated with numerous other symptoms including fetal miscarriage, hydrops fetalis, and anemia. Thus it is important to identify all infectious exposures of the patient, especially to pregnant women.
OUTLINE
Epidemiology Disease Associations Commonly Used Terms Internet Links
EPIDEMIOLOGY CHARACTERIZATION SYNONYMS Fifth disease AGE RANGE-MEDIAN 4-15 years of age Peak incidence during the winter and spring
DISEASE ASSOCIATIONS CHARACTERIZATION Arthritis and arthralgias More common in adult patients
Usually the MCP, PIP, knees, wrists, and anklesIn children, occurs in 10% of cases
Henry JB. Clinical Diagnosis and Management by Laboratory Methods. Twentieth Edition. WB Saunders. 2001.
Rosai J. Ackerman's Surgical Pathology. Ninth Edition. Mosby 2004.
Sternberg S. Diagnostic Surgical Pathology. Fourth Edition. Lipincott Williams and Wilkins 2004.
Robbins Pathologic Basis of Disease. Seventh Edition. WB Saunders 2005.
DeMay RM. The Art and Science of Cytopathology. Volume 1 and 2. ASCP Press. 1996.
Weedon D. Weedon's Skin Pathology Second Edition. Churchill Livingstone. 2002
Fitzpatrick's Dermatology in General Medicine. 5th Edition. McGraw-Hill. 1999.
Weiss SW and Goldblum JR. Enzinger and Weiss's Soft Tissue Tumors. Fourth Edition. Mosby 2001.
Basic Principles of Disease
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Commonly Used Terms
This is a glossary of terms often found in a pathology report.Diagnostic Process
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Last Updated 1/5/2004
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