The Numbered Pediatric Rashes Revisited

​I have been seeing a lot of second disease and fifth disease—it's that time of year. School is back in session, and winter is just around the corner.The rash-numbering system for these diseases is now a historical footnote, but fifth disease is still commonly used by physicians to refer to erythema infectiosum, a parvovirus. I suspect that this system was created as a memory device for similar names and the obscure Latin terms used for these diseases. Erythema infectiosum is also easy to confuse with the many other erythema rashes such as erythema migrans, erythema marginatum, erythema toxicum, and erythema multiforme. When you throw in exanthem subitum, the Latin name for roseola, one can understand why fifth disease remains part of our medical nomenclature.NameOther namesEtiologyFirstRubeola, measles, hard measlesMeasles virusSecondScarlet fever, scarlatinaStreptococcus pyogenesThirdRubella, German measles, three-day measlesRubella virusFourthFilatov-Dukes' disease, staphylococcal scalded skin syndromeNonexistent or Staphylococcus aureus strains that make exfoliative toxinFifthErythema infectiosumErythrovirus (parvovirus) B19SixthExanthem subitem (roseola infantum)Human herpes virus 6b or human herpes virus 7We are seeing a resurgence of this deadly disease because of resistance to vaccinations. Before the vaccine, measles was responsible for five to eight million deaths worldwide each year. It has a reputation of being one of the most contagious human pathogens. About...
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