Ringworm (Erythema Infectiosum)

By | June 8, 2022

Ringlet disease (erythema infectiosum), a childhood disease, is one of several possible manifestations of infection by the erythrovirus (parvovirus B19). The relatively harmless ringworm should not be confused with German measles (Rubella).

What are ringworms?

Ringworm is a common and highly contagious disease, primarily in childhood, which can also affect adults. The striking, butterfly-shaped, crimson facial rash that spreads over the cheeks is characteristic of ringworm. For heart attack guide, please visit deluxesurveillance.com.

The historical designation of ringworm as the “fifth disease” is now mainly used in English-speaking countries and comes from the original cataloging of childhood diseases that are associated with a skin rash. In most children, disease progression from ringworm is mild and requires little treatment, but it can cause significant complications if it develops in adulthood.

Children between the ages of 5 and 15 are typically affected. By the time they reach adulthood, it can be assumed that half of the adolescents will be immunized through contact with ringworm.


Ringlet disease is caused by the human erythrovirus. This human pathogenic virus is so small that it consists of only one strand of DNA. It was not verified until 1981 as the trigger of ringworm. The erythrovirus multiplies in the bone marrow via so-called progenitor cells of red blood cells and is transmitted via secretions of the respiratory tract (saliva or nasal mucus).

An infection with ringworm can also be triggered by direct contact with infected people. The time between infection and the onset of symptoms (incubation period) is usually between 4 and 21 days for ringworm. The risk of infection is particularly high in the days before the onset of symptoms.

Symptoms, Ailments & Signs

The disease progresses very differently in its severity, some people remain without symptoms and do not even realize that they are infected. The scalloped rash is the most typical sign of ringworm, although not all patients experience it. It is also called children’s erysipelas. It forms about four to fourteen days after infection.

It spreads in waves on the cheeks and forehead, it does not affect the region around the mouth. It is also called a butterfly rash because it appears symmetrically in the area around the nose in a shape resembling a butterfly. On the rest of the body, it is particularly evident on the legs, arms and buttocks.

The rash will fade a few days after it appears; but may flare up repeatedly over a longer period of time. Sunlight or heat favors this renewed outbreak. As a rule, the red spots do not cause any discomfort, in some people they cause itching.

In addition, flu-like symptoms can occur. The patient feels ill, is tired, and sometimes has a fever. Since the virus also causes anemia, the skin becomes pale. The heart rate may increase because the heart has to work harder to supply the body with enough oxygen despite the anemia.

Diagnosis & History

Most people with ringworm have no signs or symptoms. When symptoms do appear, they vary greatly depending on the age of the diseased person. Early signs and symptoms of ringworm in children may include a sore throat, low-grade fever, upset stomach, headache, fatigue, or itching. A few days after the first symptoms of ringworm appear, a distinctive bright red rash may appear on the face, usually extending to both cheeks.

In the further course, the pink and slightly raised rash extends to the arms, trunk, thighs or buttocks and already heralds the last phase of ringworm. The easily transient rash can remain in appearance for several weeks. Adults with ringworm don’t usually develop the characteristic cheek rash. Instead, joint pain in the hands, wrists, knees or ankles occurs, which can last for several weeks.


Complications from ringworm disease are rarely to be feared in healthy people. However, there is sometimes a risk for pregnant women and people who suffer from immunodeficiency.

A possible complication of erythema infectiosum is joint involvement. It becomes noticeable through painful joint inflammation, which occurs in particular in the small joints. Young women and girls are particularly affected by this impact. The duration of the symptoms varies between two weeks and a few months. In the further course they form again without any therapy.

Some complications of ringworm arise because the virus specifically targets erythrocytes (red blood cells) and their precursor cells. If a patient suffers from hemolytic anemia (anemia) at the same time, there is a risk of aplastic crises. During the course of this, the affected person’s bone marrow can temporarily no longer produce red blood cells. The parvovirus B19 is responsible for this. The aplastic crisis is often the first indication of spherical cell anemia.

Immune system defects that are congenital or acquired over the course of life result in failure to eradicate the ringworm virus. The effect of this is often chronic relapsing anemia. A typical indication is that no specific antibodies directed against the parvovirus B19 can be detected in the affected persons.

There is also a risk during pregnancy. In a third of all pregnancies, the virus affects the placenta, so that it is transmitted to the unborn child and there is a risk of severe anemia.

When should you go to the doctor?

Treatment for ringworm is often not necessary. The symptoms subside on their own within seven to fourteen days without fear of further complications. If you have a fever or flu-like symptoms such as joint pain or nausea, you should see a doctor. If the characteristic rash appears two to five days after these symptoms, a doctor must be consulted on the same day. A ringworm infection during pregnancy requires medical evaluation. The doctor will do an ultrasound scan and check if the child has the condition.

People with hemolytic anemia or a weakened immune system are also among the risk groups and should consult a doctor if the symptoms described appear. Ringworm disease can occur only once because the body produces long-term antibodies the first time it is infected. If similar symptoms occur again, there may be another underlying disease that needs to be clarified by a doctor. Ringel measles are treated by the family doctor or pediatrician. If the condition occurs in connection with an existing illness, the responsible specialist is the right person to contact.

Treatment & Therapy

Since ringworm is a relatively harmless disease, it is usually not necessary to see a doctor if it occurs in childhood. In this case, self-treatment of ringworm at home is sufficient and primarily serves to alleviate the symptoms. Because teething is an important developmental spurt, it’s important to make sure the child is drinking enough and getting plenty of rest. If the fever or pain is higher, lukewarm calf wraps or the administration of paracetamol will help.

If the child or someone in the family has a serious underlying disease that can increase the risk of complications from ringworm, a doctor must be consulted at short notice. Since the viruses that cause ringworm primarily attack the progenitor cells of the red blood cells, people with anemia are particularly at risk. In the worst case, an aplastic crisis can be triggered. These patients may require hospitalization and receive blood transfusions.

Sick people with a weakened immune system (e.g. AIDS or after organ transplants) receive antibodies via immunoglobulin injections to treat ringworm. Infection with ringworm in the first half of pregnancy can be treated with direct blood transfusion to the fetus or drugs that cross the placenta.


Lifelong immunity is acquired as a result of infection with ringworm . Since there is no preventive vaccination against ringworm, the usual hygiene measures such as hand washing or the use of unused handkerchiefs are indicated for prevention.


A ringworm infection usually heals completely within a few days and therefore does not require any special aftercare measures. Once the rash and other typical symptoms such as fever, muscle, headache and joint pain have subsided after around seven to ten days, patients can resume their usual activities without hesitation. To prevent overloading the body, the general condition of the patient should be taken into account.

Sporting activities should gradually be increased again. Longer-lasting after-effects are usually only to be expected as a result of the receding skin rash. If there is increased itching or if those affected suffer from scaly skin, common skin care products can alleviate these symptoms. However, these skin reactions usually disappear on their own after a short time.

If serious complications arose during the course of the disease, which were treated with medication according to medical instructions, special measures may also be necessary. Patients with a weakened immune system or with anemia should follow the individual instructions of their doctor.

You may have to take longer regeneration times with physical rest into account. As high-risk patients, pregnant women should also strictly follow the recommendations of their doctor. Once the ringworm infection has healed, patients can no longer be infected again. You are immune to the disease for life.

You can do that yourself

So far, there is no specific treatment for ringworm, but it usually heals on its own. The most important self-help measure is to take it easy and take the medication prescribed by your doctor.

If the child has ringworm infection, parents must provide the child with adequate fluids and bland food. A proven home remedy for itching is cooling compresses. Alternatively, you can use fatty creams from the pharmacy. In addition, the sick person should not come into contact with healthy people. It is advisable to observe the child closely so that the necessary measures can be taken immediately in the event of any complications. High fever, severe itching and persistent gastrointestinal complaints require medical evaluation. If the ringworm does not subside within two weeks, a doctor’s visit is also necessary.

If the ringworm infection occurs during pregnancy, regular follow-up checks must be used. The doctor uses an ultrasound examination to determine whether the pathogen has passed to the unborn child and, if necessary, can initiate suitable therapy. Patients with a disturbed immune system must be supplied with special antibodies if they are chronically anemic.

Ringworm (Erythema Infectiosum)