Dubois A, Thellier S, Wierzbicka-Hainaut E, Pierre F, Anyfantakis V, Guillet G
CHU de Poitiers, France.
Ann Dermatol Venereol. 2010 Nov;137(11):709-12. doi: 10.1016/j.annder.2010.06.023. Epub 2010 Sep 15.
Primary parvovirus B19 infection may present a wide variety of dermatological features. We report two cases of parvovirus infection presenting as flexural erythema of baboon syndrome induced by various drugs, but associated with purpuric or oedematous features.
A pregnant 23-year-old woman at 39 weeks of amenorrhoea and a 49-year-old woman consulted for flexural eruption in a setting of fever. In both cases, clinical examination revealed erythematosus rash in the major skin folds, with vesicles and elements of purpura in the former patient and bullous oedema in the latter. In both cases, the diagnosis of primary parvovirus B19 infection was confirmed by positive PCR screening of viral genome and by seroconversion after two weeks. The skin lesions regressed spontaneously within several days.
Although initially linked solely with systemic drug toxicity, baboon syndrome has since been reported in connection with other allergens (drug reactions, contact dermatitis, viral and streptococcal infection). Among these causes, parvovirus B19 infection merits particular interest.
原发性细小病毒B19感染可能呈现出多种多样的皮肤学特征。我们报告两例细小病毒感染病例,表现为多种药物诱发的狒狒综合征的屈侧红斑,但伴有紫癜或水肿特征。
一名孕39周的23岁孕妇和一名49岁女性因发热时出现屈侧皮疹前来就诊。在这两例病例中,临床检查均发现主要皮肤褶皱处有红斑疹,前一例患者有水泡和紫癜成分,后一例患者有大疱性水肿。在这两例病例中,通过病毒基因组的PCR筛查阳性以及两周后的血清转化,确诊为原发性细小病毒B19感染。皮肤病变在数天内自行消退。
尽管狒狒综合征最初仅与全身性药物毒性有关,但此后有报道称其与其他过敏原(药物反应、接触性皮炎、病毒和链球菌感染)有关。在这些病因中,细小病毒B19感染值得特别关注。