A 78-year-oldman developedfever andgeneral malaise on day 0, which resolvedspontaneously. On day 19, general malaise reappearedwith systemic erythema intermingledwith purpura. The presence of systemic deep lymphadenopathy and splenomegaly prompted us to consider malignant lymphoma, which was later excluded. Systemic prednisolone was started at 20 mg/day on day 21 and was increased to 60 mg/day on day 25. The rash disappeared on day 34. After day 42, anemia progressedandredbloodcell transfusion was performed. A positive Coombs test andmarked erythroidhypoplasia of the bone marrow ledto a diagnosis of autoimmune hemolytic anemia andpure cell aplasia. As serum human parvovirus B19 IgM, which hadbeen negative on day 25, became positive on day 46, the patient was diagnosed with human parvovirus B19 infection. The patient had no history of immunodeficiency or hemolytic anemia. Human parvovirus B19 infection shouldbe considered in patients presenting with purpura of unclear origin. Skin Research, 20 : 325-331, 2021