erythema

Fifth disease, also called erythema infectiosum, is a viral infection caused by parvovirus B19. This virus only infects people; it's not the same type of parvovirus that dogs and cats can get.

Fifth disease mostly affects children. It often causes a bright red rash on their cheeks (sometimes called a "slapped cheek" rash).

In the United States, parvovirus B19 infections are more common in late winter, spring, and early summer. There are usually minor outbreaks of fifth disease about every 3 to 4 years.

Parvovirus B19, which causes fifth disease, can spread from person to person:

• Through respiratory droplets, such as saliva (spit), sputum, or nasal mucus. The droplets can spread when:
  • Someone who has the virus coughs and sneezes
  • You touch an item that has the virus on it
• Through blood or blood products
• From a pregnant parent to the baby during pregnancy

You are most contagious early in your infection, when you usually only have a fever or cold-like symptoms. You are not likely to be contagious after you get later symptoms such as a rash and joint pain.

About 2 out of 10 people who get a B19 parvovirus infection will have no symptoms.

But most people will get the symptoms of fifth disease, which are usually mild and can include:

• Fever
• Headache
• Cough
• Sore throat
• Rashes
• Joint pain

The "slapped cheek" rash is more common in children. They usually get the rash a few days after they first have other symptoms. The rash can then spread to the arms, legs, chest, back, and buttocks.

Adults who get fifth disease might also have joint pain and swelling (called polyarthropathy syndrome).

Sometimes the infection can cause serious health complications affecting the nerves, joints, or blood system. This is more likely to happen if you are pregnant, have a blood disorder such as anemia, or a weakened immune system.

Because of these risks to you and some possible risks to your baby, contact your health care provider if you are pregnant and:

• You show signs of fifth disease (or a "slapped cheek" rash)
• You may have been exposed to someone who has the infection

There is no routine lab test to diagnose fifth disease. Providers can often diagnose fifth disease just by seeing the "slapped cheek" rash and rashes on the body.

There is testing to show whether or not you have protection (immunity) against the B19 parvovirus or if you have had a recent infection. This test is usually not needed, but your provider may order the test if you are pregnant or at higher risk for complications of the disease.

There is no specific treatment for fifth disease. It is usually mild and goes away on its own.

To feel better, get plenty of rest. Taking acetaminophen can help with the fever and pain. Do not give aspirin to children, because it may cause Reye syndrome. This is a rare, serious illness that can affect the brain and liver.

There is no vaccine to prevent fifth disease. But you can help protect yourself and others by:

• Washing your hands often with soap and water
• Covering your mouth and nose when you cough or sneeze
• Avoiding touching your eyes, nose, and mouth with unwashed hands
• Avoiding close contact with people who are sick
• Staying home when you are sick

Most people become immune to the virus after having it once.

Centers for Disease Control and Prevention

Your skin is your body's largest organ. It covers the entire outside of your body. There are many ways that your skin protects your body and helps keep you healthy. For example, it:

• Holds body fluids in, which helps prevent you from getting dehydrated
• Keeps out harmful germs, which helps prevent infections
• Helps you feel things like heat, cold, and pain
• Helps control your body temperature
• Makes vitamin D when the sun shines on it
• Shields your body against heat and light

There are many different problems and conditions which can affect your skin. Some of them can cause uncomfortable symptoms, such as itching, burning, redness, and rashes. They might also affect your appearance. Some of the more common skin conditions include:

• Acne, which causes pimples when hair follicles under your skin get clogged up
• Burns
• Cuts and scrapes
• Dandruff, flaking of the skin on your scalp (the top of your head)
• Eczema (atopic dermatitis), which causes inflammation, redness, and irritation of the skin
• Hives, which are red and sometimes itchy bumps on your skin
• Insect bites
• Psoriasis, which causes itchy, scaly red patches
• Skin cancer
• Skin infections

Since your skin protects your body in many ways, it's important to try to keep your skin healthy. For example, you can:

• Wear the right protective equipment, like gloves, long sleeves, knee and elbow pads, or helmets to protect against cuts, bumps and scrapes.
• If you do get a cut or scrape, clean it right away with soap and warm water. Put on a bandage to protect it while it heals.
• When you are spending time outdoors, wear long sleeves and pants and use insect repellant to prevent insect bites.
• Prevent sunburn by covering up and using sunscreen when outdoors.
• Wash your hands often with soap and water.
• When you take a shower or bath, use warm (not hot) water. Use mild cleansers and wash gently (don't scrub).
• Use moisturizers, like lotions, creams, or ointments, to prevent dry skin.

NIH: National Institute of Arthritis and Musculoskeletal and Skin Diseases

Your skin is your body's largest organ. It has many different functions, including covering and protecting your body. It helps keep germs out. But sometimes the germs can cause a skin infection. It often happens when the germs enter your body through a break, cut, or wound on your skin. Other skin infections can happen in places where the skin rubs together, especially if the area is moist. Infections can also happen when you have a poor blood supply to an area of your body or if your immune system is weakened because of another disease or a medical treatment.

Some skin infections cover a small area on the top of your skin. Other infections can go deep into your skin or spread to a larger area.

Skin infections are caused by different kinds of germs. For example,:

• Bacteria cause cellulitis, impetigo, and staphylococcal (staph) infections
• Viruses cause shingles, warts, and herpes simplex
• Fungi cause athlete's foot and yeast infections
• Parasites cause body lice, head lice, and scabies

You are more likely to get a skin infection if you:

• Have poor circulation
• Have diabetes
• Are older
• Have an immune system disease, such as HIV
• Have a weakened immune system because of chemotherapy or other medicines that suppress your immune system
• Have to stay in one position for a long time, such as if you are sick and have to stay in bed for a long time or you are paralyzed
• Are malnourished
• Have excessive skinfolds, which can happen if you have obesity

The symptoms depend on the type of infection. Some symptoms that are common to many skin infections include rashes, swelling, redness, pain, pus, and itching.

To diagnose a skin infection, your health care provider will do a physical exam and ask about your symptoms. You may have lab tests, such as a skin culture. This is a test to identify what type of infection you have, using a sample from your skin. Your provider may take the sample by swabbing or scraping your skin or removing a small piece of skin (biopsy). Sometimes providers use other tests, such as blood tests.

The treatment depends on the type of infection and how serious it is. Some infections will go away on their own. When you do need treatment, it may include a cream or lotion to put on the skin. Other possible treatments include medicines and a procedure to drain pus.

An allergy is a reaction by your immune system to something that does not bother most other people. People who have allergies often are sensitive to more than one thing. Substances that often cause reactions are:

• Pollen
• Dust mites
• Mold spores
• Pet dander
• Food
• Insect stings
• Medicines

Normally, your immune system fights germs. It is your body's defense system. In most allergic reactions, however, it is responding to a false alarm. Genes and the environment probably both play a role.

Allergies can cause a variety of symptoms such as a runny nose, sneezing, itching, rashes, swelling, or asthma. Allergies can range from minor to severe. Anaphylaxis is a severe reaction that can be life-threatening. Doctors use skin and blood tests to diagnose allergies. Treatments include medicines, allergy shots, and avoiding the substances that cause the reactions.

It is hard when your baby is sick. Common health problems in babies include colds, coughs, fevers, and vomiting. Babies also commonly have skin problems, like diaper rash or cradle cap.

Many of these problems are not serious. It is important to know how to help your sick baby, and to know the warning signs for more serious problems. Trust your intuition - if you are worried about your baby, call your health care provider right away.

Most of the time, medicines make our lives better. They reduce aches and pains, fight infections, and control problems such as high blood pressure or diabetes. But medicines can also cause unwanted reactions, such as drug interactions, side effects, and allergies.

A drug interaction is a change in the way a drug acts in the body when taken with certain other drugs, foods, or supplements or when taken while you have certain medical conditions. Examples include:

• Two drugs, such as aspirin and blood thinners
• Drugs and food, such as statins and grapefruit
• Drugs and supplements, such as gingko and blood thinners
• Drugs and medical conditions, such as aspirin and peptic ulcers

Interactions could cause a drug to be more or less effective, cause side effects, or change the way one or both drugs work.

Side effects are unwanted, usually unpleasant, effects caused by medicines. Most are mild, such as a stomachache, dry mouth, or drowsiness, and go away after you stop taking the medicine. Others can be more serious. Sometimes a drug can interact with a disease that you have and cause a side effect. For example, if you have a heart condition, certain decongestants can cause you to have a rapid heartbeat.

Drug allergies are another type of reaction. They can range from mild to life-threatening. Skin reactions, such as hives and rashes, are the most common type. Anaphylaxis, a serious allergic reaction, is less common.

When you start a new prescription or over-the-counter medicine, make sure you understand how to take it correctly. Know which other medicines, foods, and supplements you need to avoid. Always talk to your health care provider or pharmacist if you have questions about your medicines.

Herpes is an infection that is caused by a herpes simplex virus (HSV). Oral herpes causes cold sores around the mouth or face. Genital herpes affects the genitals, buttocks or anal area. Genital herpes is a sexually transmitted infection (STI). It affects the genitals, buttocks or anal area. Other herpes infections can affect the eyes, skin, or other parts of the body. The virus can be dangerous in newborn babies or in people with weak immune systems.

There are two types of HSV:

• HSV type 1 most commonly causes cold sores. It can also cause genital herpes.
• HSV type 2 is the usual cause of genital herpes, but it also can infect the mouth.

HSV spreads through direct contact. Some people have no symptoms. Others get sores near the area where the virus has entered the body. They turn into blisters, become itchy and painful, and then heal.

Most people have outbreaks several times a year. Over time, you get them less often. Medicines to help your body fight the virus can help lessen symptoms and decrease outbreaks.

Lyme disease is a bacterial infection you get from the bite of an infected tick. At first, Lyme disease usually causes symptoms such as a rash, fever, headache, and fatigue. But if it is not treated early, the infection can spread to your joints, heart, and nervous system. Prompt treatment can help you recover quickly.

Lyme disease is caused by bacteria. In the United States, this is usually a bacterium called Borrelia burgdorferi. It spreads to humans through the bite of an infected tick. The ticks that spread it are blacklegged ticks (or deer ticks). They are usually found in the:

• Northeast
• Mid-Atlantic
• Upper Midwest
• Pacific coast, especially northern California

These ticks can attach to any part of your body. But they are often found in hard-to-see areas such as your groin, armpits, and scalp. Usually, the tick must be attached to you for more than 24 hours to spread the bacterium to you.

Most tick bites happen in the warmer months (April-September), when ticks are most active and people spend more time outdoors. But you can also get bitten during the rest of the year, especially if the temperatures are warmer than usual.

Most tick bites happen in the summer months when ticks are most active and people spend more time outdoors. But you can get bitten in the warmer months of early fall, or even late winter if temperatures are unusually high. And if there is a mild winter, ticks may come out earlier than usual.

Early symptoms of Lyme disease start between 3 to 30 days after an infected tick bites you. The symptoms can include:

• A red rash called erythema migrans (EM). Most people with Lyme disease get this rash. It gets bigger over several days and may feel warm. It is usually not painful or itchy. As it starts to get better, parts of it may fade. Sometimes this makes the rash look like a "bull's-eye."
• Fever
• Chills
• Headache
• Fatigue
• Muscle and joint aches
• Swollen lymph nodes ("swollen glands")

If the infection is not treated, it can spread to your joints, heart, and nervous system. The symptoms may include:

• Severe headaches and neck stiffness.
• More EM rashes on other areas of your body.
• Facial palsy, which is a weakness in your facial muscles. It can cause drooping on one or both sides of your face.
• Arthritis with severe joint pain and swelling, especially in your knees and other large joints.
• Pain that comes and goes in your tendons, muscles, joints, and bones.
• Heart palpitations, which are feelings that your heart is skipping a beat, fluttering, pounding, or beating too hard or too fast.
• An irregular heart beat (Lyme carditis).
• Episodes of dizziness or shortness of breath.
• Inflammation of the brain and spinal cord.
• Nerve pain.
• Shooting pains, numbness, or tingling in the hands or feet.

To make a diagnosis, your health care provider will consider:

• Your symptoms
• How likely it is that you were exposed to infected blacklegged ticks
• How likely it is that you could have other illnesses that cause similar symptoms
• The results of any lab tests

Most Lyme disease tests check for antibodies made by the body in response to infection. These antibodies can take several weeks to develop. If you are tested right away, it may not show that you have Lyme disease, even if you have it. So you may need to have another test later.

Lyme disease is treated with antibiotics. The earlier you are treated, the better; it gives you the best chance of fully recovering quickly.

After treatment, some patients may still have pain, fatigue, or difficulty thinking that lasts more than 6 months. This is called post-treatment Lyme disease syndrome (PTLDS). Researchers don't know why some people have PTLDS. There is no proven treatment for PTLDS; long-term antibiotics have not been shown to help. However, there are ways to help with the symptoms of PTLDS. If you have been treated for Lyme disease and still feel unwell, contact your health care provider about how to manage your symptoms. Most people do get better with time. But it can take several months before you feel better.

To prevent Lyme disease, you should lower your risk of getting a tick bite:

• Avoid areas where ticks live, such as grassy, brushy, or wooded areas. If you are hiking, walk in the center of the trail to avoid brush and grass.
• Use an Environmental Protection Agency (EPA)-registered insect repellent when you go outdoors. They are evaluated to make sure they are safe and effective. Make sure that the repellant has one of these ingredients: DEET, picaridin, IR3535, oil of lemon eucalyptus, or para-menthane-diol. It is important to follow the instructions on the label.
• Treat your clothing and gear with a repellant containing 0.5% permethrin
• Wear light-colored protective clothing, so you can easily see any ticks that get on you
• Wear a long-sleeved shirt and long pants. Also tuck your shirt into your pants and your pant legs into your socks.
• Check yourself, your children, and your pets daily for ticks. Carefully remove any ticks you find.
• Take a shower and wash and dry your clothes at high temperatures after being outdoors

Centers for Disease Control and Prevention

Sarcoidosis is a condition in which groups of cells in your immune system form small, red, and swollen (inflamed) lumps. These lumps are called granulomas. They can form in any organ in the body. But they most commonly affect the lungs and lymph nodes in the chest. Over time, sarcoidosis can cause permanent scarring of organs.

Your immune system creates inflammation to help defend you against germs and sickness. But in sarcoidosis, inflammation goes off track. It causes the cells in your immune system to form granulomas. Studies suggest that this inflammation might be triggered by infections and certain substances in the environment such as insecticides and mold. And your genes may affect how your immune system reacts to a trigger.

Anyone can develop sarcoidosis, but you are more likely to have it if you:

• Are older, especially if you are over age 55
• Live or work near insecticides, mold, or other substances that may cause inflammation
• Have a close relative who has sarcoidosis
• Take certain medicines, such as some types of HIV medicines and monoclonal antibodies
• Are of African or Scandinavian descent
• Are female

Many people who have sarcoidosis have no symptoms, or they may feel unwell but without any obvious symptoms. If you have symptoms, you may have some general symptoms. And you may have other symptoms, which will depend upon which part of the body is affected.

The general symptoms can include:

• Fatigue
• Weight loss
• Swollen lymph nodes
• Depression
• Fever
• Night sweats (heavy sweating during sleep)

The symptoms of sarcoidosis in the lungs can include:

• Wheezing
• Cough
• Shortness of breath
• Chest pain

The symptoms of sarcoidosis in other parts of the body can include:

• Larger than normal liver or spleen
• Jaundice, which can make your eyes or skin yellow
• Nervous system problems, such as:
  • Headache
  • Dizziness
  • Vision problems
  • Seizures
  • Numbness or tingling
• Heart palpitations or an irregular heartbeat (arrhythmia)
• Pain and swelling in the joints
• Skin problems such as rashes and growths under the skin

There is also a set of symptoms that are called Lofgren's syndrome. Some people have Lofgren's syndrome when they first develop sarcoidosis. It usually goes away completely within 2 years. The symptoms of Lofgren's syndrome may include:

• Swollen lymph nodes in your chest, neck, chin, armpits, or groin.
• A rash of small, itchy, or painful bumps called erythema nodosum. The rash is most often on your head, neck, or legs.
• Blurred vision, eye pain or redness, light sensitivity, or watery eyes.
• Joint pain, stiffness, or swelling.
• Fever.

If untreated, or if the treatment does not work, sarcoidosis can cause serious health problems called complications. Possible complications include:

• Lung problems
• Heart problems
• Hormone problems
• Brain, nerve, or muscle problems
• Kidney problems
• Severe organ damage

There is no single test that can diagnose sarcoidosis, and its symptoms can be similar to the symptoms of many other conditions. That makes it hard to diagnose. To find out if you have sarcoidosis, your health care provider:

• Will ask about your medical history, including your symptoms, lifestyle, and any other health conditions you may have.
• Will do a physical exam, which may include:
  • Checking your temperature
  • Checking to see if your lymph nodes, spleen, or liver are swollen
  • Listening to your chest with a stethoscope as you breathe in and out
  • Looking for rashes or sores on your body, such as scalp and lower legs
• Will likely order various tests, such as:
  • Chest x-rays
  • A biopsy of the skin, lymph nodes, lungs, or other affected organs
  • Blood tests to check your blood counts, hormone levels, and how well your kidneys are working
  • Other imaging tests

If you are diagnosed with sarcoidosis, your provider may order other tests to look at how sarcoidosis is affecting the body.

There is no cure for sarcoidosis. The goal of treatment for sarcoidosis is remission, which means you still have the condition, but it does not cause you problems.

You may not need treatment, and sometimes the condition goes away on its own. If you do need treatment, which treatment(s) you get will depend on your symptoms, which organs are affected, and whether those organs are working well. You may be given medicines to:

• Lower inflammation
• Treat an overactive immune response
• Treat joint pain
• Treat skin problems

If you have complications from sarcoidosis, you may need other treatments, such as other medicines, surgery, oxygen therapy, pulmonary rehabilitation, or an implanted cardiac pacemaker or defibrillator.

Whether or not you have symptoms from sarcoidosis, it's important to get regular follow-up care from your provider, make healthy lifestyle changes, and contact your provider if you have any new symptoms.

NIH: National Heart, Lung, and Blood Institute