Skin Rash Could Be Fifth's Disease

Sue Hubbard, M.D.

Even though summer has arrived in most parts of the nation, I'm still seeing typical spring illnesses like Fifth's disease. Fifth's disease is a common viral illness seen in children, often in the late winter and spring.

Many of these patients look like they've developed a little "sunburn" on their faces, as they often show up in the office with a "slapped cheek" rash. They may also have a lacy red rash on their arms and legs, and occasionally even on their trunks. Fifth's is also called erythema infectiosum, so named as it's the fifth of six rashes associated illness of childhood.

Fifth's disease is caused by Parvovirus B19, a virus that infects humans. This is not the same parvovirus that infects dogs or cats. Your child will not give it to their pet or vice a versa.

In most cases, a child may have very few symptoms of illness, other than the rash. In some cases, a child may have had a low-grade fever, a runny nose, or a few days of "not feeling well" before the rash develops. The rash may be so insignificant as to not be noticed.

When I see a child with Fifth's disease, it's usually an easy diagnosis based on their few symptoms and the typical rash. Although children with Fifth's are probably contagious at some time during the illness, it's thought that by the time the rash occurs, the contagious period has passed. This is why you never know where you got this virus; the incubation period is somewhere between 4-20 days after exposure.

Parvovirus B19 may be found in respiratory secretions and is probably spread by person-to-person contact. During outbreaks, it's been reported that somewhere between 10 percent and 60 percent of students in a class may become infected. Most adults have had Fifth's disease but may not remember it, as up to 20 percent of those infected don't develop symptoms.

Fifth's disease is another one of those viral diseases that resolves on its own. I like to refer to the treatment as "benign neglect," as there is nothing to do. The rash may take anywhere from 7-10 days to heal.

I do tell parents that the rash may seem to come and go for a few days and seem to be exacerbated by sunlight and heat. It's not uncommon to see a child come in from playing on a hot sunny day and the rash is more obvious on sun exposed areas. Occasionally, a child will complain of itching. You can use a soothing lotion such as Sarna or even Benadryl for relief. A cool shower or bath at the end of a summer day may work just as well.

Children who are immunocompromised, or who have sickle cell disease, leukemia, or cancer, may not handle the virus as well as other kids and should be seen by their pediatrician. But in most cases there's no need to worry about Fifth's disease.

Dr. Sue Hubbard is a nationally known pediatrician and co-host of "The Kid's Doctor" radio show.

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Health - Skin Rash Could Be Fifth's Disease