S ir , Human parvovirus (HPV) B19 infection shows a wide spectrum of cutaneous manifestations and, especially in adults, systemic involvement. 1 –5 Acute hepatitis and hepatic disorders are rare. 6 A 41‐year‐old woman developed a skin eruption with pyrexia and constitutional symptoms. She denied any drug intake or exposure to children or adults with exanthematous diseases. The disease started acutely with pyrexia (39.5 °C), fatigue, headache, anorexia, nausea, vomiting, chills, profuse sweating and arthralgia/myalgia. A burning eruption began in the right axilla and spread, 2 days later, to the arms and then to the contralateral axilla, trunk and legs. Examination showed an erythematous and purpuric eruption localized to the axillae ( Fig. 1 ), trunk and extremities. The lesions were intensely purpuric in the folds. The hands and feet were spared. There was no hepatosplenomegaly nor palpable lymph nodes. Normal tests included full blood count, prothrombin time, muscle enzymes (creatine phosphokinase and aldolase) and urinalysis. 1 . An atypical erythematous and purpuric eruption is evident at the right axilla. The peripheral blood monocyte count was raised at 0.09 × 10 9 /L (normal 0.02–0.08 × 10 9 ) with 0.028 × 10 9 /L reactive lymphocytes. The
British Journal of Dermatology – Wiley
Published: Jul 1, 1999
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