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August 6, 1982

Fifth Disease: Still Hazy After All These Years

JAMA. 1982;248(5):553-554. doi:10.1001/jama.1982.03330050035026

Ninety-three years ago, in 1889, Tschamer1 described and defined "örtliche Rötheln," a curious childhood exanthem characterized by "slapped cheek" appearance with a lacy reticular rash of the extremities. Although it has been alleged that British dermatologist Robert Willan2 observed the illness in the late 1700s as "rubeola sine catarrho," his description of the latter is unarguably of a different condition, as most probably is that of "roseola annulata."3

In 1899 Sticker4 named the illness—by then recognized in Western Europe—erythema infectiosum, and six years thereafter, Cheinisse5 coined the term "fifth rash disease" (abbreviated "fifth disease") in deference to the four exanthematous diseases of childhood then acknowledged to be distinct on clinical and epidemiologic grounds: scarlet fever, rubeola, rubella, and epidemic pseudoscarlatina (Dukes' disease).6 The intervening years have seen further clinical and epidemiologic clarification of fifth disease as a benign condition occurring sporadically in focal school