Mucocutaneous manifestations of viral diseases in children

Abstract

There are numerous types of viruses that manifest themselves as dermatologic disorders in children. Some of these affect the skin alone, but many of them are associated with or are even harbingers of serious systemic disease. This contribution disusses the most common viral conditions to affect the skin, as well as some that are less well known. Current treatments and preventive measures for many of these diseases are also considered. There are several groups of viruses that produce mucocutaneous lesions in children: herpesviruses, papovaviruses, poxviruses, picornaviruses, and retroviruses. In addition, there are various other viruses that can have cutaneous manifestations, such as human parvovirus B19, rubella, rubeola, and hepatitis B and C, among others.1 Finally, there are other dermatological disorders and exanthems thought to be viral in nature but that have yet to demonstrate a particular viral etiology. All herpesviruses may have manifestations dermatologic: herpes simplex viruses 1 and 2 (HSV-1 and HSV-2, respectively); varicella zoster virus (VZV); Epstein-Barr virus; cytomegalovirus (CMV); and human herpesviruses 6, 7, and 8 (HHV-6, HHV-7, and HHV-8, respectively). Human papillomavirus (HPV) is a papovavirus that may affect children, especially if they are immunocompromised. Poxviruses, such as molluscum contagiosum (MC), milker’s nodules, and orf, can also present in the pediatric population. Coxsackieviruses are the most common picornavirus infections that cause skin disorders in children. Finally, HIV is a retrovirus well known to cause not only cutaneous but also severe systemic disease and death in children. Fortunately, many of these disorders have good treatments, which, when they are recognized early, can significantly reduce morbidity and mortality. Some may be prevented through immunization with licensed vaccines (Table 1),2 and others are the subjects of experimental preventive and therapeutic vaccination. There is still need, however, for ongoing study of those for which no good treatment or vaccine exists.