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June 1995

Acute Generalized Livedo Reticularis With Myasthenialike Syndrome Revealing Parvovirus B19 Primary Infection

Author Affiliations


Department of Dermatology and Phlebology Hôpital Saint-Charles 300 Avenue A. Broussonnet Centre Hospitalier Regional Universitaire Montpellier 34059 Montpellier Cedex, France

Arch Dermatol. 1995;131(6):744-745. doi:10.1001/archderm.1995.01690180124033

Human parvovirus B19 has been recognized as the causative agent of a number of cutaneous eruptions, including classic erythema infectiosum or fifth disease; some less well-defined, often purpuric, acute exanthematous eruptions; vasculitis; and the recently described petechial glove-and-sock syndrome.1,2 On the other hand, acute infection with parvovirus B19 may trigger a number of visceral manifestations. We report a new cutaneous manifestation of parvovirus B19 as a primary infection with a striking generalized livedo reticularis, occurring simultaneously with an impressive myasthenialike muscular weakness.

Report of a Case.  A 29-year-old woman was first referred to our institution in December 1993 for the evaluation of a recent, generalized livedo reticularis with fever and general alteration in her health. Her medical history was unremarkable, and she denied taking any medication. The disease began about 4 days before her admission to the hospital; it had an acute onset, consisting of a temperature as high as 40°C and chills, rapidly followed by generalized and increasing muscular weakness, and, eventually, by an extensive livedo reticularis. Initial examination revealed an acutely ill, febrile patient (temperature, 38°C) with myalgias and impressive

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