Review
Viral exanthems: An update on laboratory testing of the adult patient

https://doi.org/10.1016/j.jaad.2016.08.034Get rights and content

Although classic viral exanthems of childhood are well described, they are rarely differentiated in adults. Laboratory techniques for viral identification have advanced without substantial literature to suggest how a dermatologist ought to conduct a cost-effective and diagnostic viral panel. Certain clinical features such as petechiae, vesicles, and dusky macular or morbilliform exanthems point strongly toward a viral exanthem. Differentiation of drug and viral causes of morbilliform eruptions has proven difficult. It is possible that with further diagnostic refinement that unnecessary and fruitless workups of an exanthem and unneeded discontinuation of drugs can be avoided. We review viral exanthems based on clinical features and discuss the available and optimal laboratory techniques to assist the dermatologist in a targeted workup.

Key words

Cost-effectiveness
laboratory tests
morbilliform eruption
polymerase chain reaction
serology
viral antigen tests
viruses

Abbreviations used

CDC
Centers for Disease Control and Prevention
CHIKV
chikungunya virus
CMV
cytomegalovirus
CV
Coxsackie virus
EBV
Epstein-Barr virus
HFMD
hand-foot-and-mouth disease
HHV
human herpesvirus
PCR
polymerase chain reaction
RT
reverse transcription

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Funding sources: None.

Conflicts of interest: None declared.

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