Last reviewed:September 2019
Last updated:December  2017



History and exam

Key diagnostic factors

  • close contact with other infected individuals
  • bright red macular erythema of the bilateral cheeks with sparing of the nasal ridge and perioral areas
  • erythematous macules and papules evolving into lacy reticular erythema, most notable on the extremities
  • immunodeficiency

Other diagnostic factors

  • arthralgia/arthritis
  • prodrome (fever, headache, pharyngitis, coryza, abdominal pain)
  • symptoms of anemia

Risk factors

  • close contact with other infected individuals
  • immunodeficiency

Diagnostic investigations

Investigations to consider

  • CBC
  • reticulocyte count
  • serology
  • DNA assays
Full details

Treatment algorithm


Assistant Professor of Dermatology and Pediatrics CUMC

Columbia University Medical Center

New York



CTL was a participant in the 2014 Leo Pharma Advisory Panel.

Dr Christine T. Lauren would like to gratefully acknowledge Dr Jon Dyer and Dr Jennifer Holman, the previous contributors to this monograph. JD and JH declare that they have no competing interests.

Peer reviewersVIEW ALL


Department of Pathology and Laboratory Medicine

Children's and Women's Health Centre of British Columbia




NC declares that he has no competing interests.

Use of this content is subject to our disclaimer