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Paravirale Exantheme

Paraviral exanthems

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Zusammenfassung

Unter paraviralen Exanthemen sind distinkte Hauterkrankungen aufzufassen, die auf Infektionen mit unterschiedlichen Viren zurückzuführen sind. Auch wenn sich bisher bei einigen Exanthemerkrankungen kein Virus identifizieren ließ, sprechen doch das Manifestationsalter der Patienten, der klinische Verlauf des Exanthems und extrakutane Symptome für eine virale Genese. Während viele Virusexantheme direkte Folge der Infektion darstellen, reflektieren paravirale Exantheme die Antwort des Immunsystems auf die Infektionserreger. Viren lassen sich dann nicht in der Haut nachweisen. Zu typischen paraviralen Exanthemen gehören Gianotti-Crosti-Syndrom, Pityriasis rosea, Pityriasis lichenoides, „papular-purpuric gloves and socks syndrome“ sowie das asymmetrische periflexurale Exanthem. Das unilaterale mediothorakale Exanthem und die eruptive Pseudoangiomatose sind selten, und die eruptive Hypomelanose wurde erst kürzlich beschrieben.

Abstract

Paraviral exanthems are distinct skin diseases due to infections with different viruses. Although no virus has been identified so far in some exanthems, the main age of manifestation, the clinical course of the exanthem, and the extracutaneous symptoms are suggestive for a viral genesis. While many viral infections are a direct result of the infection, paraviral exanthems reflect the response of the immune system to the infectious pathogens. Viruses cannot be identified in the skin. Typical paraviral exanthems include Gianotti–Crosti syndrome, pityriasis rosea, pityriasis lichenoides, papular-purpuric gloves and sock syndrome, and asymmetrical periflexural exanthema. Unilateral mediothoracic exanthem, eruptive pseudoangiomatosis are rare and eruptive hypomelanosis has been described recently.

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Literatur

  1. Alratrout J, Alshammasi F, Ansari N (2016) Febrile ulceronecrotic Mucha-Habermann disease in an 8‑year-old boy responding to methotrexate. Int J Dermatol 55(11):1205–1209

    Article  CAS  PubMed  Google Scholar 

  2. Babu TA, Arivazhahan A (2015) Gianotti-Crosti Syndrome following immunization in an 18 months old child. Indian Dermatol Online J 6(6):413–415

    Article  PubMed  PubMed Central  Google Scholar 

  3. Bowers S, Warshaw EM (2006) Pityriasis lichenoides and its subtypes. J Am Acad Dermatol 55:557–572

    Article  PubMed  Google Scholar 

  4. Cherry JD, Bobinski JE, Horvath FL et al (1969) Acute hemangioma-like lesions associated with ECHO viral infections. Pediatrics 44:498–502

    CAS  PubMed  Google Scholar 

  5. Chuh A, Bharatia P, Zawar V (2016) Eruptive hypomelanosis in a young child as a „paraviral exanthem“. Pediatr Dermatol 33(1):e38–9

    Article  PubMed  Google Scholar 

  6. Chuh A, Dofitas B, Comisel G et al (2007) Interventions for pityriasis rosea. Cochrane Database Syst Rev 2:CD005068

    Google Scholar 

  7. Chuh A, Fölster-Holst R, Zawar V (2016) Managements of the less common paraviral exanthems in children – asymmetrical periflexural exanthem, papular-purpuric gloves and socks syndrome, eruptive pseudoangiomatosis, and eruptive hypomelanosis. Eur J Pediat Dermatol 26:25–29

    Google Scholar 

  8. Chuh A, Panzer R, Rosenthal AC, Proksch E, Kempf W, Zawar V, Fickenscher H, Fölster-Holst R (2016) Annular eruptive pseudoangiomatosis and adenovirus infection: a novel clinical variant of paraviral exanthems and a novel virus association. Acta Derm Venereol. doi:10.2340/00015555-2541.

    Google Scholar 

  9. Chuh A, Zawar V (2016) Unilateral mediothoracic exanthem – report of the third patient in the literature. Int J Trop Dis Health 13:1–4

    Article  Google Scholar 

  10. Chuh A, Zawar V, Lee A (2005) Atypical presentations of pityriasis rosea: case presentations. J Eur Acad Dermatol Venereol 19(1):120–126

    Article  CAS  PubMed  Google Scholar 

  11. Chuh A, Zawar V, Lee A, Sciallis G (2016) Is Gianotti-Crosti syndrome associated with atopy? A case-control study and a postulation on the intrinsic host factors in Gianotti-Crosti syndrome. Pediatr Dermatol 33(5):488–492

    Article  PubMed  Google Scholar 

  12. Chuh A, Zawar V, Maheshwari A, Bharatia P (2016) A mini-epidemic of eruptive hypomelanosis in three children of the same family; the first piece of epidemiological evidence for an infectious cause of a novel paraviral exanthem. Clin Exp Dermatol 41(6):680–681

    Article  CAS  PubMed  Google Scholar 

  13. Chuh A, Zawar V, Sciallis G, Kempf W (2016) A position statement on the management of patients with pityriasis rosea. J Eur Acad Dermatol Venereol 30(10):1670–1681

    Article  CAS  PubMed  Google Scholar 

  14. Chuh A, Zawar V, Sciallis G, Law M (2012) Gianotti-Crosti syndrome, pityriasis rosea, asymmetrical periflexural exanthem, unilateral mediothoracic exanthem, eruptive pseudoangiomatosis, and papular-purpuric gloves and socks syndrome – succinct reviews and arguments. Infect Dis Rep 4(1):12. doi:10.4081/idr.2012.e12

    Article  Google Scholar 

  15. Drago F, Broccolo F, Javor S, Drago F, Rebora A, Parodi A (2014) Evidence of human herpesvirus-6 and -7 reactivation in miscarrying women with pityriasis rosea. J Am Acad Dermatol 71:198–199

    Article  PubMed  Google Scholar 

  16. Drago F, Broccolo F, Zaccaria E et al (2008) Pregnancy outcome in patients with pityriasis rosea. J Am Acad Dermatol 58(5):S78–S83

    Article  PubMed  Google Scholar 

  17. Elena-González A, Lozano-Durán C, Cuadros-Tito P, Gete-García L (2014) Papular-purpuric gloves and socks syndrome and thrombocytopenia related to parvovirus B19 infection. Enferm Infecc Microbiol Clin 32:61–62

    Article  PubMed  Google Scholar 

  18. Ersoy-Evans S, Greco MF, Mancini AJ, Subaşi N, Paller AS (2007) Pityriasis lichenoides in childhood: a retrospective review of 124 patients. J Am Acad Dermatol 56(2):205–210

    Article  PubMed  Google Scholar 

  19. Fölster-Holst R, Zawar VP, Chuh A (2016) Paraviral exanthems. Expert Rev Anti Infect Ther 14(6):601–611

    Article  PubMed  Google Scholar 

  20. Gameiro A, Gouveia M, Tellechea Ó, Moreno A (2014) Childhood hypopigmented mycosis fungoides: a commonly delayed diagnosis. BMJ Case Rep 23:2014

    Google Scholar 

  21. Geller L, Antonov NK, Lauren CT, Morel KD, Garzon MC (2015) Pityriasis lichenoides in childhood: review of clinical presentation and treatment options. Pediatr Dermatol 32:579–592

    Article  PubMed  Google Scholar 

  22. Haug S, Schnopp C, Ring J, Fölster-Holst R, Abeck D (2002) Gianotti-Crosti syndrome following immunization. Hautarzt 53(10):683–685

    Article  CAS  PubMed  Google Scholar 

  23. Kaneda A, Matsusaka K, Aburatani H et al (2012) Epstein-barr virus infection as an epigenetic driver of tumorigenesis. Cancer Res 72:3445–3450

    Article  CAS  PubMed  Google Scholar 

  24. Kempf W, Kazakov DV, Palmedo G, Fraitag S, Schaerer L, Kutzner H (2012) Pityriasis lichenoides et varioliformis acuta with numerous CD30(+) cells: a variant mimicking lymphomatoid papulosis and other cutaneous lymphomas. A clinicopathologic, immunohistochemical, and molecular biological study of 13 cases. Am J Surg Pathol 36:1021–1029

    Article  PubMed  Google Scholar 

  25. Kreuter A, Knispel S, Wieland U, Oellig F, Tigges C (2016) Complete resolution of febrile ulceronecrotic Mucha-Habermann disease following infliximab therapy. J Dtsch Dermatol Ges 14(2):184–186

    PubMed  Google Scholar 

  26. Loukeris D, Serelis J, Aroni K, Tsakris A, Voulgarelis M (2005) Simultaneous occurrence of pure red cell aplasia and papular-purpuric „gloves and socks“ syndrome in parvovirus B‑19 infection. J Eur Acad Dermatol Venereol 19:373–376

    Article  CAS  PubMed  Google Scholar 

  27. Mahajan K, Relhan V, Relhan AK, Garg VK (2016) Pityriasis Rosea: An update on etiopathogenesis and management of difficult aspects. Indian J Dermatol 61(4):375–384

    Article  PubMed  PubMed Central  Google Scholar 

  28. Nofal A, Alakad R, Assaf M, Nofal E (2016) A fatal case of febile ulceronecrotic Mucha-Habermann disease in a child. JAAD Case Rep 2(2):181–185

    Article  PubMed  PubMed Central  Google Scholar 

  29. Ozyürek GD, Alan S, Cenesizoğlu E (2014) Evaluation of clinico-epidemiological and histopathological features of pityriasis rosea. Postepy Dermatol Alergol 31(4):216–221

    Article  PubMed  PubMed Central  Google Scholar 

  30. Rosman IS, Liang LC, Patil S, Bayliss SJ, White AJ (2013) Febrile ulceronecrotic Mucha-Habermann disease with central nervous system vasculitis. Pediatr Dermatol 30:90–93

    Article  PubMed  Google Scholar 

  31. Sklavounou-Andrikopoulou A, Iakovou M, Paikos S, Papanikolaou V, Loukeris D, Voulgarelis M (2004) Oral manifestations of papular-purpuric „gloves and socks“ syndrome due to parvovirus B19 infection: the first case presented in Greece and review of the literature. Oral Dis 10(2):118–122

    Article  CAS  PubMed  Google Scholar 

  32. Toyoshima MT, Keller LW, Barbosa ML, Durigon EL (2006) Papular-purpuric „gloves and socks“ syndrome caused by parvovirus B19 infection in Brazil: a case report. Braz J Infect Dis 10(1):62–64

    Article  PubMed  Google Scholar 

  33. Zawar V, Bharatia P, Chuh A (2014) Eruptive hypomelanosis: a novel exanthem associated with viral symptoms in children. JAMA Dermatol 150(11):1197–1201

    Article  PubMed  Google Scholar 

  34. Zawar V, Chuh A (2017) A case-control study on the association of pulse oral poliomyelitis vaccination and Gianotti-Crosti syndrome. Int J Dermatol 56(1):75–79

    Article  PubMed  Google Scholar 

  35. Zheng Y, Jia J, Tian Q, Dong X, Wang X, Ying Z, Xiao S, Li W (2014) Lymphomatoid papulosis misdiagnosed as pityriasis lichenoides et varioliformis acuta: Two case reports and a literature review. Exp Ther Med 8(6):1927–1933

    PubMed  PubMed Central  Google Scholar 

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Author information

Authors and Affiliations

  1. Dermatologie, Venerologie und Allergologie, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Rosalind-Franklin-Str. 7, 24105, Kiel, Deutschland

    R. Fölster-Holst

  2. School of Public Health and Primary Care, The Chinese University of Hong Kong and Prince of Wales Hospital, Shatin, Hong Kong, Volksrepublik China

    V. Zawar

  3. Department of Dermatology, Godavari Foundation Medical College and Research Center, DUPMCJ, Nashik, Indien

    A. Chuh

Authors
  1. R. Fölster-Holst
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  2. V. Zawar
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  3. A. Chuh
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Corresponding author

Correspondence to R. Fölster-Holst.

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Interessenkonflikt

R. Fölster-Holst, V. Zawar und A. Chuh geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren.

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Fölster-Holst, R., Zawar, V. & Chuh, A. Paravirale Exantheme. Hautarzt 68, 211–216 (2017). https://doi.org/10.1007/s00105-017-3940-5

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