Which disease presents with 'slapped cheeks' and a lacy rash on the arms and legs?

Which disease presents with 'slapped cheeks' and a lacy rash on the arms and legs?

• A. 5th disease
• B. 6th disease
• C. 4th disease
• D. 3rd disease

Answer: (A)

The pattern described—bright red, slapped-cheek appearance followed a few days later by a delicate, lace-like (reticular) rash on the arms and legs—is classic for erythema infectiosum, the fifth disease. It’s caused by parvovirus B19. In children, the illness often starts with mild symptoms or a low-grade fever, then the cheeks become strikingly red, giving that “slapped cheeks” look. A few days after the facial redness, a reticular, lacey rash appears on the trunk and limbs; the rash can wax and wane for weeks and may worsen with heat or sun. This presentation helps distinguish it from roseola (which has a high fever that breaks before a general body rash appears), and from rubella or measles, which have distinct prodromes and rash patterns (not the characteristic slapped-cheek plus lacey body rash). Management is mainly supportive; the infection is usually mild in healthy children. Pregnancy is a special concern because parvovirus B19 infection can, in rare cases, cause fetal anemia and hydrops, so exposure should be discussed with a clinician.

The pattern described—bright red, slapped-cheek appearance followed a few days later by a delicate, lace-like (reticular) rash on the arms and legs—is classic for erythema infectiosum, the fifth disease. It’s caused by parvovirus B19. In children, the illness often starts with mild symptoms or a low-grade fever, then the cheeks become strikingly red, giving that “slapped cheeks” look. A few days after the facial redness, a reticular, lacey rash appears on the trunk and limbs; the rash can wax and wane for weeks and may worsen with heat or sun.

This presentation helps distinguish it from roseola (which has a high fever that breaks before a general body rash appears), and from rubella or measles, which have distinct prodromes and rash patterns (not the characteristic slapped-cheek plus lacey body rash). Management is mainly supportive; the infection is usually mild in healthy children. Pregnancy is a special concern because parvovirus B19 infection can, in rare cases, cause fetal anemia and hydrops, so exposure should be discussed with a clinician.