Patients experience a mild, brief illness; complaints include fever, malaise, headache, and pruritus. The characteristic erythema appears about 10 days later. Facial redness is similar to that which occurs when a child is slapped; however, circumoral redness is absent. Several days following initial erythema, a less distinct rash may appear on the extremities and trunk. The rash usually resolves within 1 week but may occur for several weeks when the patient is exposed to heat, cold, exercise, or stress. Adults may also experience arthralgia and arthritis although these symptoms are less common in children. In addition, mild transient anemia, thrombocytopenia, and leukopenia may develop.