Symptoms
Ringworm (erythema infectiosum) occurs mainly in children and during the cold season and manifests itself in flu-like symptoms such as fever, feeling sick, headache, muscle aches, sore throat, and nausea. A typical feature is the red rash on the face, which looks as if the child has been slapped in the face (“ear slap disease”). The nose, mouth and eyes are left out. Later, a patchy papular rash appears on the trunk and extremities, which may be itchy. The disease usually heals within 1-2 weeks, but the rash may recur months later. Possible triggers include sunlight, heat, emotions, and physical activity. Joint pain is most common with adult-onset disease and is rare in children.
Causes
The cause of the disease is infection with human parvovirus B19, a single-stranded and nonenveloped DNA virus of the parvovirus family that replicates in blood stem cells. Transmission usually occurs as a droplet infection in childhood, but can also be passed in blood, blood products, and from mother to child. The virus can cause various clinical pictures in adults and special patient groups, which are not discussed in this article.
Diagnosis
Diagnosis is usually made in pediatric patients on the basis of the typical rash and with laboratory methods. Other childhood diseases that also present with a rash must be ruled out.
Treatment
The condition usually passes on its own and does not require specific treatment. Acetaminophen or nonsteroidal anti-inflammatory drugs such as ibuprofen can be used for drug therapy of pain, fever, and inflammation. Acetylsalicylic acid (aspirin) is not recommended. For example, baths with tannins (e.g., Tannosynt), cold compresses, and shaking brushes help to relieve itching; see also under Itching.
Prevention
Good hand hygiene is recommended as a preventive measure. A vaccine is not currently available. Pregnant women should not come into contact with the virus because this can lead to infection of the child, complications, and miscarriage. Contact should also be avoided in immunocompromised individuals.
