Incidencia y características clínicas de los exantemas maculopapulares de etiología viral

Alonso, Tomás Vega; Costa, Milagros Gil; Recio, M. Jesús Rodríguez; Higuera, P. de la Serna

doi:10.1016/s0212-6567(03)70781-1

Cited by 15 publications

(6 citation statements)

References 14 publications

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“…198–200 HB19EV infection, for example, might lead to erythema infectiosum, PPGSS, or other clinical presentations. Asymptomatic virus shedding is common.…”

Section: Diagnostic Criteriamentioning

confidence: 99%

“…From community and public health perspectives, surveillance of these rashes is important as the viral etiologies, clinical significance, and the rates of complications are still unclear. 198 – 200 HB19EV infection, for example, might lead to erythema infectiosum, PPGSS, or other clinical presentations. Asymptomatic virus shedding is common.…”

Section: Diagnostic Criteriamentioning

confidence: 99%

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Gianotti-Crosti Syndrome, Pityriasis Rosea, Asymmetrical Periflexural Exanthem, Unilateral Mediothoracic Exanthem, Eruptive Pseudoangiomatosis and Papular-Purpuric Gloves and Socks Syndrome: A Brief Review and Arguments for Diagnostic Criteria

Chuh

Zawar²,

Law

et al. 2012

Infectious Disease Reports

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Several exanthems including Gianotti-Crosti syndrome, pityriasis rosea, asymmetrical periflexural exanthem, eruptive pseudoangiomatosis, and papular-purpuric gloves and socks syndrome are suspected to be caused by viruses. These viruses are potentially dangerous. Gianotti-Crosti syndrome is related to hepatitis B virus infection which is the commonest cause of hepatocellular carcinoma, and Epstein-Barr virus infection which is related to nasopharyngeal carcinoma. Pityriasis rosea has been suspected to be related to human herpesvirus 7 and 8 infections, with the significance of the former still largely unknown, and the latter being a known cause of Kaposi's sarcoma. Papular-purpuric gloves and socks syndrome is significantly associated with human B19 erythrovirus infection which can lead to aplastic anemia in individuals with congenital hemoglobinopathies, and when transmitted to pregnant women, can cause spontaneous abortions and congenital anomalies. With viral DNA sequence detection technologies, false positive results are common. We can no longer apply Koch's postulates to establish cause-effect relationships. Biological properties of some viruses including lifelong latent infection, asymptomatic shedding, and endogenous reactivation render virological results on various body tissues difficult to interpret. We might not be able to confirm or refute viral causes for these rashes in the near future. Owing to the relatively small number of patients, virological and epidemiology studies, and treatment trials usually recruit few study and control subjects. This leads to low statistical powers and thus results have little clinical significance. Moreover, studies with few patients are less likely to be accepted by mainstream dermatology journals, leading to publication bias. Aggregation of data by meta-analyses on many studies each with a small number of patients can theoretically elevate the power of the results. Techniques are also in place to compensate for publication bias. However, these are not currently feasible owing to different inclusion and exclusion criteria in clinical studies and treatment trials. The diagnoses of these rashes are based on clinical assessment. Investigations only serve to exclude important differential diagnoses. A wide spectrum of clinical features is seen, and clinical features can vary across different populations. The terminologies used to define these rashes are confusing, and even more so are the atypical forms and variants. Previously reported virological and epidemiological results for these rashes are conflicting in many aspects. The cause of such incongruence is unknown, but low homogeneity during diagnosis and subject recruitment might be one of the factors leading to these incongruent results. The establishment and proper validation of diagnostic criteria will facilitate clinical diagnosis, hasten recruitment into clinical studies, and allow results of different studies to be directly compared with each another. Meta-analyses and systematic reviews would be more valid. Diagn...

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“…198–200 HB19EV infection, for example, might lead to erythema infectiosum, PPGSS, or other clinical presentations. Asymptomatic virus shedding is common.…”

Section: Diagnostic Criteriamentioning

confidence: 99%

Section: Diagnostic Criteriamentioning

confidence: 99%

Gianotti-Crosti Syndrome, Pityriasis Rosea, Asymmetrical Periflexural Exanthem, Unilateral Mediothoracic Exanthem, Eruptive Pseudoangiomatosis and Papular-Purpuric Gloves and Socks Syndrome: A Brief Review and Arguments for Diagnostic Criteria

Chuh

Zawar²,

Law

et al. 2012

Infectious Disease Reports

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“…Despite the relatively high frequency of this problem, epidemiologic data are scarce ( Folster-Holst and Kreth, 2009a ). The estimated prevalence of maculopapular virus-linked exanthemas is estimated to be 158.3/10,000 (CI: 142.3–174.4) ( Vega Alonso et al, 2003 ). Based on typical morphological feature, six classical exanthemas have been described at the beginning of the 20th century, i.e., measles or rubeola, scarlet fever, rubella, Filatow–Dukes disease (fourth disease), erythema infectiosum (fifth disease), and exanthem subitum (sixth disease) ( Keighley et al, 2015 ).…”

Section: Pathomechanismsmentioning

confidence: 99%

Viral Infections and Cutaneous Drug-Related Eruptions

et al. 2021

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In the general population, up to 10% of children treated by antibiotics have cutaneous adverse drug reaction, but allergy is confirmed in less than 20% of patients. Most of the non-allergic reactions are probably due to virus, such as enterovirus acute infection or Ebstein-Barr Virus (EBV) acute infection or reactivation. Especially in children, viruses have the propensity to induce skin lesions (maculopapular rash, urticaria) due to their skin infiltration or immunologic response. In drug-related skin eruptions, a virus can participate by activating an immune predisposition. The culprit antibiotic is then the trigger for reacting. Even in severe drug-induced reactions, such as Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) syndrome, viruses take part in immune phenomena, especially herpes viruses. Understanding the mechanisms of both virus- and drug-induced skin reaction is important to develop our clinical reflection and give an adaptive care to the patient. Our aim is to review current knowledge on the different aspects and potential roles of viruses in the different type of drug hypersensitivity reactions (DHR). Although major advances have been made those past year, further studies are needed for a better understanding of the link between viruses and DHR, to improve management of those patients.

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“…The estimated incidence of maculopapular viral exanthemas is 158.3/10.000 (C.I. 142.3–174.4) 12 and when occurring during a drug course treatment it makes the diagnosis of drug hypersensitivity challenging. Clinically is very difficult or even impossible to differentiate a rash of viral origin from a drug reaction.…”

Section: Introductionmentioning

confidence: 99%

How to manage drug-virus interplay underlying skin eruptions in children

Mori,

Liccioli,

Tomei

et al. 2024

World Allergy Organization Journal

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Incidencia y características clínicas de los exantemas maculopapulares de etiología viral

Cited by 15 publications

References 14 publications

Gianotti-Crosti Syndrome, Pityriasis Rosea, Asymmetrical Periflexural Exanthem, Unilateral Mediothoracic Exanthem, Eruptive Pseudoangiomatosis and Papular-Purpuric Gloves and Socks Syndrome: A Brief Review and Arguments for Diagnostic Criteria

Gianotti-Crosti Syndrome, Pityriasis Rosea, Asymmetrical Periflexural Exanthem, Unilateral Mediothoracic Exanthem, Eruptive Pseudoangiomatosis and Papular-Purpuric Gloves and Socks Syndrome: A Brief Review and Arguments for Diagnostic Criteria

Viral Infections and Cutaneous Drug-Related Eruptions

How to manage drug-virus interplay underlying skin eruptions in children

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