Triggering factors causing different skin manifestations based on age

Dr Barbara M. Mathes is a clinical associate in dermatology at the University of Pennsylvania and president of the Women’s Dermatologic Society.

Can the same triggering factor cause varying skin manifestations depending on age (children as compared with adults)?

Barbara M. Mathes, MD: Can a triggering factor produce something on the skin that looks different in children than it looks in adults? I would say yes, to some extent. Many rashes look the same in adults and children or are triggered by the same thing except when we get to viruses. I think a classic example is chickenpox. It occurs in children due to the varicella zoster virus, but when you get the virus as a child with chickenpox, it never goes away, it can be reactivated, and it shows up in the adult as shingles or herpes zoster.

Another example is the parvovirus B19. Children get it in a condition called fifth disease or erythema infectiosum, which causes a rash on their cheek and their chest; we call it “slapped-cheek disease,” as the cheeks get very red. But when adults get that rash, when they get the virus, they often get a rash on their hands and feet, called “gloves-and-socks” disease.

So the same virus shows up differently in adults and in children, but most other rashes look the same.