Viruses – Boston Exanthem Disease

Boston Exanthem Disease occured in Boston as an epidemic and I have not enountered it in my The Woodlands dermatology and Conroe dermatology clinics.  It is caused by echovirus 16 and the rash begins as red macules and papules that can even become vesicular (blister like).  The face, chest and back are the predominant places involved by the rash.  Occasionally, patients develop ulcers on the soft palate and tonsils similar to herpangina with no lymphadenopathy.  The incubation time for development of symptoms after exposure to the virus is 3 to 7 days.