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Infection with parvovirus B19 is clinically recognized most often as erythema infectiosum (EI), or fifth disease, which is characterized by a distinctive rash that may be preceded by mild systemic symptoms, including fever in 15% to 30% of patients. The facial rash can be intensely red with a “slapped cheek” appearance that often is accompanied by circumoral pallor. A symmetric, macular, lace-like, and often pruritic rash occurs on the trunk, moving peripherally to involve the arms, buttocks, and thighs. The rash can fluctuate in intensity and can recur with environmental changes, such as temperature and exposure to sunlight,...

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