What are the other Names for this Condition? (Also known as/Synonyms)

• Boston Exanthem
• Boston Exanthem (Echovirus 16) Infection

What is Boston Exanthem Disease? (Definition/Background Information)

• Boston Exanthem Disease is an extremely rare skin infection that was first recorded in the city of Boston in the US. It first occurred as an epidemic outbreak in 1951 in Boston, affecting children, and then in 1954 in Pittsburgh
• The condition is marked by the presence of red-pink skin lesions on the body. The lesions can even occur inside the mouth. Children, including infants and newborn babies, are affected much more than adults
• Boston Exanthem Disease is caused by the echovirus 16. No clear risk factors for the infection have been established
• Treatment is generally asymptomatic and it may involve the use of skin creams and ointments. The prognosis of Boston Exanthem Disease is generally good with suitable treatment

Note: The last few cases were recorded in 1974 within USA (from 8 states), and some cases were reported from Cuba in the year 2000.

Who gets Boston Exanthem Disease? (Age and Sex Distribution)

• Boston Exanthem Disease is a highly infrequent skin condition that may form at any age. However, infants and children are affected much more than adults
• Both males and females are affected and there is no gender bias observed
• All racial and ethnic groups are at risk

What are the Risk Factors for Boston Exanthem Disease? (Predisposing Factors)

• Currently, no risk factors have been identified for Boston Exanthem Disease
• The condition is mostly observed in young children

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases one’s chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Boston Exanthem Disease? (Etiology)

• Boston Exanthem Disease is a viral infection that is caused by the human echovirus 16 (a type of RNA virus)
• The condition is highly-contagious and can spread from one individual to another

What are the Signs and Symptoms of Boston Exanthem Disease?

The signs and symptoms of Boston Exanthem Disease may include:

• Presence of pink macules and papules in the head and neck region, although any skin site may be involved (chest and back)
• The period of incubation of the condition is between 3 to 8 days
• The cluster of lesions is not densely packed, but are often scattered around the body region
• In the mouth (or oral mucosa), the condition can result in tiny ulcer formation that may involve the soft palate and tonsils
• The presence of these skin rashes is usually associated with fever
• No enlargement of lymph nodes is generally observed
• Severe skin conditions may be present as fluid-filled red rashes or resembling measles infection

How is Boston Exanthem Disease Diagnosed?

A Boston Exanthem Disease is diagnosed through the following tools:

• Complete physical examination with evaluation of medical history
• Dermoscopy: It is a diagnostic tool where a dermatologist examines the skin using a special magnified lens
• Wood’s lamp examination: In this procedure, the healthcare provider examines the skin using ultraviolet light. It is performed to examine the change in skin pigmentation
• Tissue culture: A culture may be performed to confirm the presence of virus and to rule-out other causes of infection. In this culture, a small amount of pus or fluid from one of the sores is collected and sent to the lab for testing. The test results can help confirm the presence and type of virus (if any)
• Skin biopsy: A skin biopsy is performed and sent to a laboratory for a pathological examination. The pathologist examines the biopsy under a microscope. After putting together clinical findings, special studies on tissues (if needed) and with microscope findings, the pathologist arrives at a definitive diagnosis

Note: In a majority of cases, no skin biopsy or tissue culture is necessary. But, they may be performed if there is an area of concern, or to rule out other conditions presenting similar signs and symptoms.

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Boston Exanthem Disease?

There are frequently no complications that arise from Boston Exanthem Disease.

• Nevertheless, in some individuals, it may give rise to cosmetic concerns and stress
• Scratching or itching of the moles may lead to bleeding and ulceration. This can cause secondary bacterial or fungal infections to develop
• The potential spread of the condition to other children and adults is high

How is Boston Exanthem Disease Treated?

The treatment measures for Boston Exanthem Disease include:

• Symptomatic treatment of the condition
• Application of topical creams and ointments, based on the healthcare providers assessment
• Follow-up care with regular screening and check-ups are encouraged

How can Boston Exanthem Disease be Prevented?

Current medical research has not established a method of preventing the occurrence of Boston Exanthem Disease.

What is the Prognosis of Boston Exanthem Disease? (Outcomes/Resolutions)

The prognosis of Boston Exanthem Disease is good with appropriate symptomatic treatment. It is not known to cause any severe complications.

Additional and Relevant Useful Information for Boston Exanthem Disease:

• Cleaning the skin too hard with strong chemicals or soaps may aggravate the skin condition. Care must be taken avoid strong soaps and chemicals that could potentially worsen the condition
• The presence of dirt on the body is not a causative factor for the condition. However, it helps to be clean and hygienic, which may help the condition from getting worse