A strange rash with "gloves and socks" distribution (original) (raw)
A strange rash- Scaparrotta et al
The papular-purpuric gloves and socks syndrome (PPGSS) is a new acral dermatosis first described in adults in 1990 and successively described in some children . Pruritic and painful edema and erythema are the characteristic features, with subsequent acral petechiae localized to the distal upper and lower extremities as gloves and socks distribution. Sometimes, it is associated with mucosal lesions and systemic symptoms such as fever, asthenia and lymphadenopathy .
A case report of papular-purpuric gloves and socks syndrome: A manifestation of the parvovirus B19
International Journal of Case Reports and Images, 2016
Introduction: the majority of parvovirus b19 infections are asymptomatic. In childhood, however, they may present as the fifth disease and in adults their manifestations can vary from mild, non-specific, cold-like symptoms to other forms of presentations. Papular-purpuric gloves and socks syndrome (PPGss) is an uncommon form of parvovirus b19 infection, characterized by symmetric, pruriginous and painful erythema and edema of feet and hands. Generally, systemic symptoms are usually mild and dissemination to other body regions occurs in only 50% of the cases. the rash gradually progresses to petechiae and purpura delineating well demarcated "socks" and "gloves" on both feet and hands. the diagnosis is predominantly based on the clinical features. serologic conversion is not considered as evidence of parvovirus b19 infection and histopathological findings from lesional skin are not specific. there are no definite antiviral
Turkish Journal of Emergency Medicine, 2014
ÖZET Makül, papül, vezikül ve püstüllerle seyreden hastalıklara döküntülü hastalıklar denir. Pek çok viral enfeksiyon, jeneralize morbiliform deri döküntüleri ile ilişkilidir. Papüler purpurik eldiven ve çorap sendromu (PPGSS), insan parvovirus B19 virüsünün sebep olduğu klinik bir durumdur. El ve ayaklarda simetrik eldiven ve çorap tarzı lezyonlar ile beraberinde ağızda lezyonlar ve ateş vardır. Otuz beş yaşında kadın hasta el ve ayaklarda papüler simetrik döküntü, aftöz orofarengeal lezyonlar ve ateş ile başvurdu. Fizik muayenesinde el-ayaklarda simetrik döküntüler ve ağızda aftöz lezyonlar mevcuttu. Parvovirus Ig M pozitif saptanan hasta semptomatik tedavi uygulanarak taburcu edildi.
Papular purpuric gloves and socks syndrome. Presentation of a clinical case
Medicina oral, patología oral y cirugía bucal, 2007
Papular-Purpuric Glove-and-Sock Syndrome is a rare, infectious disease, of viral etiology, characterized by the presence of pruritus, edema and symmetrical erythema, very well defined at the wrists and ankles with a gloves-and-socks distribution. Other areas can be affected, with a moderate erythema appearing in cheeks, elbows, knees, armpits, abdomen, groin, external genitalia, internal face of the thighs and the buttocks. Erosions, small ulcers, enanthema and blisters can be observed in the oral cavity and lips, and less frequently in other mucous membranes. Complications are rare, although they can be severe, 50% of the published cases are related with the Parvovirus B19. Due to its oral involvement stomatologists should be aware of this syndrome in order to carry out a correct diagnosis of the disease.
Papular-purpuric "gloves and socks" syndrome due to parvovirus B19 infection in childhood [letter]
Pediatric Dermatology, 1998
Papular purpuric gloves and socks syndrome (also known as gloves and socks syndrome) is a relatively newly described viral dermatosis with unique characteristics. These characteristics typically include an erythematous, papular, or petechial rash and edema in an acral distribution, often with associated mucosal lesions, arthralgias, and fever. We present a case of papular purpuric gloves and socks syndrome in a 46-year-old patient with acute parvovirus B19 infection, review the descriptive literature, and summarize our evolving understanding of this disease.
Parvovirus B19 associated papular-purpuric gloves-and-socks syndrome
… Turkish journal of …, 2006
The papular-purpuric gloves-and-socks syndrome (PPGSS) is a disease characterized by an itching erythema and edema of the hands and feet, oral mucosal lesions and fever. It may be caused by various agents. Parvovirus B19 has been implicated as the etiological factor in most cases. Here we report a case of PPGSS in a nine-year-old previously healthy girl with papular and petechial lesions on her peroral area and trunk, and primarily on the dorsal areas of her hands and feet. Serologic study confirmed the acute infection by parvovirus B19. We believe that our case is worthy of particular attention because of the rarity of the disease in the pediatric age group and because it is the first documented case of PPGSS in Turkey.
Journal of the American Academy of Dermatology, 1999
We report a typical case of papular-purpuric "gloves and socks" syndrome (PPGSS) in which primary infection by parvovirus B19 was demonstrated by seroconversion to this virus; parvovirus B19 DNA was also identified by polymerase chain reaction (PCR) methods in the sera of the patient and in the cutaneous biopsy specimen, both taken 4 days after the onset of clinical manifestations. To our knowledge, this is the fourth published case in which parvovirus B19 DNA has been recovered from the skin by PCR. Serologic studies and PCR investigations in cutaneous biopsy for other viruses including herpes simplex virus types 1 and 2, varicella zoster virus, Epstein-Barr virus, cytomegalovirus, and human herpesvirus 6, 7, and 8 were negative. Clinically, our case presented some additional features, which have not been previously described in cases of PPGSS, namely dysuria with vulvar edema and erythema, and unilateral petechial rash on the breast. The histopathologic findings of our case were nonspecific and consisted of an interface dermatitis with slight vacuolar degeneration at the dermoepidermal junction and a superficial perivascular inflammatory infiltrate mostly composed of lymphocytes, with numerous extravasated erythrocytes. We review the cases of PPGSS published in the literature with respect to the different viruses that have been proposed as etiologic agents and conclude that acute infection by parvovirus B19 is the only one that has been adequately proved. aAm Acad DermatoI1999;41:793-6.)
Erythematous papular rash with sparing of folds
JAAD Case Reports
A 48-year-old Jamaican woman presented with several months of pruritus and a diffuse, erythematous scaly rash on the face, trunk, and extremities. At this time, there was no sparing of the folds. She was preemptively treated with triamcinolone 0.1% ointment and oral prednisone, 10 mg, for atopic dermatitis or contact dermatitis with minimal improvement. Laboratory values were significant for lymphocytosis and absolute eosinophilia. Biopsy found an atypical lymphoid infiltrate in the papillary dermis and epidermis (Fig 1). Nine months after initial presentation, the rash transformed into perifollicular red-brown papules that spared body folds and doublecoverage areas (Figs 2 to 4). No palmoplantar hyperkeratosis or nail changes were noted. Repeat biopsy findings
Juvenile papular-purpuric gloves and socks syndrome
Journal of the European Academy of Dermatology and Venereology, 2001
Papular-purpuric gloves and socks syndrome (PPGSS) occurs mainly in young adults, but it should also be considered in the differential diagnosis of childhood exanthems. The case presented here is the youngest patient hitherto reported with PPGSS and supports the concept of a viral genesis.
Pruritic Erythematous Rashes on Face and Eyelids
Pediatric Autoimmunity and Transplantation, 2019
A 13-year-old girl presented with erythematous, violaceous rash with poikiloderma of the face and eyelids, as well as violaceous papules of the hands overlying the joints and the proximal nail fold (Fig. 15.1a, b), starting some 8-years ago. Myalgia and muscle weakness had associated these lesions since the past 2 years. Her personal and family histories were unremarkable. Skin examination revealed lilac erythema of the upper eyelids which were also edematous. Closer examination revealed violaceous poikiloderma of the cheek and forehead and lichenoid papules on the skin overlying interphalangeal and metacarpophalangeal joints and proximal nail folds, along with cuticular dystrophy and nail fold telangiectasia (Fig. 15.1a, b). No muscle weakness was found in systematically performed neurological examinations and her muscle strength was 5 out of 5. The rest of her physical examinations were unremarkable. Complete blood count, hepatic and renal function tests, complement levels (C3, C4), and serum creatine kinase were within the normal range. ESR was elevated to 34 mm/h and anti-nuclear antibodies was positive. Skin biopsy demonstrated basal vacuolar degeneration and minimal interstitial mucin accumulation in epidermis, along with homogenization and chronic band-like lichenoid lymphohistiocytic inflammation in papillary dermis (Fig. 15.2). Direct immunofluorescence (DIF) showed fibrinogen deposition in papillary dermis. Q1. What is the most likely diagnosis? A. Clinically amyopathic juvenile dermatomyositis B. Subacute cutaneous lupus erythematosus C. Lichen planus D. Systemic lupus erythematosus
Papular Purpuric Rash Due to Parvovirus B19 with Distribution on the Distal Extremities and the Face
Clinical Infectious Diseases, 2002
We describe 3 patients who presented with a distinctive clinical picture of the purpuric rash called "gloves-and-socks syndrome" which was characterized by an acral distribution of the rash that involved not only the distal part of the extremities but also the chin and perioral area. Serologic analysis for parvovirus B19 yielded positive results. Parvovirus B19 should be included in the evaluation of febrile purpura.
Rapid Onset of Purpuric Rash in an Otherwise Healthy 6-Month-Old Infant
Clinical pediatrics, 2016
A 6-month-old boy of eastern Mediterranean descent was referred to the emergency department of Larnaca General Hospital with 1-day history of purpuric rash. The lesions initially appeared on the face and rapidly progressed to edema and purpuric lesions of the extremities. The infant had been in good health until the day of presentation. Two days before the lesions occurred, the patient was inoculated with his 6-month vaccines (against diphtheria, tetanus, acellular pertussis, poliomyelitis and Haemophilus influenzae type B). The mother stated that the boy had eaten strawberries for the first time, 3 hours prior to his current presentation. There was no history of preceding infection or medication intake. The boy was born at term with a normal labor following an uneventful pregnancy. He was the first child of healthy nonrelated parents. Physical examination revealed a lively, well-developed, well-nourished infant with no toxic appearance. His vital signs revealed normal temperature, respiratory rate of 25 breaths per minute, blood pressure of 90/60 mm Hg, and oxygen saturation of 99% on room air. There were multiple indolent, palpable, purpuric, cutaneous lesions on the face and limbs (Figure ). The trunk, diaper area, and mucosal sites were spared. Most skin lesions presented with centrifugal development, symmetrical distribution and oval or round shape. Some of the lesions had well-defined edges and their size reached up to 4 cm in diameter while others merged to form large purpuric lesions with polycyclic borders. The purpuric rash was accompanied by mild nonpainful edema on ears and lower extremities. There was no passive restriction of joint movements or signs of joint effusion. The remainder clinical examination, including a complete neurological examination, was unremarkable. Full blood count revealed normal hemoglobin, leukocytosis, eosinophilia, and thrombocytosis. Erythrocyte sedimentation rate, C-reactive protein, complement component 3, coagulation tests, and liver function tests were all within normal values. Antistreptolysin and veneral disease research laboratory tests were negative, urinalysis was normal and no blood was detected in the feces. Quantitative immunoglobulin testing for IgG, IgA, and IgM was within normal values. Acute hemorrhagic edema of infancy (AHIE).