From the Research
Causes of Viral Exanthem
- Viral exanthems are common in childhood and can be caused by various viruses, including parvovirus, Epstein-Barr virus (EBV), human herpesvirus 6 (HHV6), and cytomegalovirus (CMV) 1, 2, 3
- The bacterium Mycoplasma pneumoniae can also cause exanthema either from the infection itself or due to interaction with drugs taken simultaneously 3
- Viral exanthems can be self-limited, but some can be signs of more significant systemic disease, especially in pregnant or immunocompromised individuals 2
Clinical Presentations of Viral Exanthem
- The clinical presentation of viral exanthems in children includes a polymorphic spectrum of skin eruptions, ranging from classic viral exanthems to "atypical" presentations that can mimic nonviral diseases 1
- Viral exanthems can appear as papular purpuric gloves and socks syndrome, pityriasis rosea, unilateral lateral thoracic exanthem, and Gianotti-Crosti syndrome 2
- Skin eruptions can be mistaken for drug hypersensitivity, and determination of the exact diagnosis requires a careful clinical history and thorough physical examination 3
- Atypical manifestations of Gianotti-Crosti syndrome and hand, foot, and mouth disease can also occur 4
Diagnosis and Management
- Early recognition and differentiation from other childhood illnesses are important to direct further investigations and treatment initiation 1
- Haematological and biochemical investigations and histology are not always helpful in differentiating between viral and drug-induced exanthema 3
- Serological and polymerase chain reaction (PCR) assays can be helpful, although a concomitant acute infection does not exclude drug hypersensitivity 3
- A systematic clinical approach is proposed for timely differential diagnosis and management of rashes in children who present a cutaneous eruption while receiving a drug 3