Paraviral exanthems

Expert Rev Anti Infect Ther. 2016 Jun;14(6):601-11. doi: 10.1080/14787210.2016.1184084.


Introduction: Paraviral exanthems are skin diseases suspected to be caused by viruses, with a single virus-exanthem relationship not universally accepted. Although most paraviral exanthems are self-remitting, accurate diagnoses are important as some patients might develop complications. Some of the differential diagnoses might cause serious complications, and some paraviral exanthems might lead to complications for at-risk groups such as pregnant women. Moreover, some paraviral exanthems might be symptomatic such as the development of severe pruritus, with relief of such being crucial in the plan of management. Patients and carers of patients should also be counselled regarding the aetiologies, clinical features, and prognoses of the exanthems concerned.

Areas covered: We covered the clinical manifestations and managements of pityriasis rosea, pityriasis lichenoides, and Gianotti-Crosti syndrome. Expert Commentary: Most patients with pityriasis rosea do not need any active intervention. Symptomatic relief of the pruritus would be adequate. For patients with pityriasis rosea that are serious, extensive, or causing severe impacts of their quality of life, oral acyclovir could be considered. For pityriasis lichenoides, managements would be depending on the type of the exanthem such as the acute form (pityriasis lichenoides et varioliformis acuta, also known as Mucha Habermann disease) the chronic form (pityriasis lichenoides chronic Juliusberg's disease), and the febrile ulceronecrotic Mucha-Habermann disease, which is a complication of the acute form. The management of Gianotti-Crosti syndrome is mainly symptomatic. The need for long-term follow-up for chronic complications of the underlying viral infections is still controversial.

Keywords: Exanthems; Gianotti-Crosti syndrome; paraviral exanthems; pityriasis lichenoides; pityriasis lichenoides chronica; pityriasis lichenoides et varioliformis acuta; pityriasis rosea.

Publication types

  • Review

MeSH terms

  • Acrodermatitis / drug therapy*
  • Acrodermatitis / virology
  • Anti-Bacterial Agents / administration & dosage
  • Anti-Bacterial Agents / therapeutic use
  • Anti-Inflammatory Agents / administration & dosage
  • Anti-Inflammatory Agents / therapeutic use
  • Antiviral Agents / administration & dosage
  • Antiviral Agents / therapeutic use
  • Combined Modality Therapy
  • Diagnosis, Differential
  • Exanthema / drug therapy*
  • Exanthema / virology
  • Humans
  • Phototherapy / methods
  • Pityriasis Lichenoides / drug therapy*
  • Pityriasis Lichenoides / virology
  • Pityriasis Rosea / drug therapy*
  • Pityriasis Rosea / virology
  • Skin Diseases, Viral / drug therapy*


  • Anti-Bacterial Agents
  • Anti-Inflammatory Agents
  • Antiviral Agents