Pictorial Case Study - The case

A 10-year-old boy presented with his mother with a maculopapular itchy rash which began over his cheeks but spread to his arms and legs. He had mild flu-like symptoms a few days before it appeared. Another child in his class had red cheeks a week or two ago. What are the diagnosis, management and differential diagnoses?


The boy has erythema infectiosum, also called 'slapped cheek' disease or fifth disease. It is a parvovirus infection that predominantly affects children between the ages of five and 15. Parents, or people working with children, are also liable to infection. By the time symptoms show, the person is no longer infectious. He and his mother were reassured that he had a self-limiting viral illness, which did not require specific treatment.

- Measles.
- Rubella.
- Scarlet fever.


- Incubation period usually one to two weeks.
- Patients infectious four days before onset and five days after.
- Fever, barking cough, sore throat, conjunctivitis and photophobia.
- Koplik's spots can be seen before the rash appears.
- Non-itchy maculopapular then blotchy rash usually begins around the
ears and spreads to the body and the legs within a day or two.
- When the red rash disappears it may leave brown stains.

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