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A strange rash with "gloves and socks" distribution.

Scaparrotta A, Rossi N, Attanasi M, Petrosino MI, Di Pillo S, Chiarelli F - Arch Med Sci (2015)

View Article: PubMed Central - PubMed

Affiliation: Department of Pediatrics, "G. D'Annunzio" University, Chieti, Italy.

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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... On physical examination, the child showed erythematous and papular large itching lesions on the upper and lower limbs, characteristic of strophulus, and especially notable erythema and edema of the hands and feet, with a sharp demarcation at the level of the wrists and ankles of healthy skin (Figures 1 A and B)... He did not show lesions of the oral mucosa, genital and conjunctival or hepato-splenomegaly... Therefore, the diagnosis of PPGSS related to parvovirus B19 infection was made... There was also sporadic association with other viruses such as varicella zoster, EBV, CMV, HSV 6-7, Coxsackie, hepatitis B, and rubella... Prodromal or associated symptoms may be fever, asthenia, anorexia, arthralgia, myalgia, lymphadenopathy, lesions of the mucous membranes, and gastrointestinal symptoms... The symptomatic variety of PPGSS requires differential diagnosis with other rheumatologic and hematologic diseases: lymphoproliferative disorders, thrombocytopenic syndromes, Kawasaki disease, leukocytoclastic or hypersensitivity vasculitis (cryoglobulinemic vasculitis and Henoch-Schonlein purpura) and Still's disease... In most cases it needs only symptomatic treatment with antipyretics and non-steroidal anti-inflammatory drugs, avoiding the use of corticosteroids, because it is a self-limiting disease and immunosuppressive therapy may promote the persistence of the virus... Since the first description in 1990, about 90 cases of PPGSS have been described in the literature, with 74 items reported in PubMed for papular-purpuric gloves and socks syndrome, while only 34 items result when adding the filter of age (birth to 18 years)... Papular-purpuric gloves and socks syndrome, although rare in children, must be taken into account as an unusual clinical manifestation of infection by parvovirus B19, which differs from the fifth disease (or infectious erythema), the much more common disease caused by this virus in children, mainly by location, characteristics of the rash and accompanying symptoms... A correct diagnosis is important to avoid unnecessary laboratory tests and treatment.

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Erythema and edema of the hands with sharp demarcation at the level of the wrists of healthy skin
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Figure 0001: Erythema and edema of the hands with sharp demarcation at the level of the wrists of healthy skin

Mentions: On physical examination, the child showed erythematous and papular large itching lesions on the upper and lower limbs, characteristic of strophulus, and especially notable erythema and edema of the hands and feet, with a sharp demarcation at the level of the wrists and ankles of healthy skin (Figures 1 A and B). He did not show lesions of the oral mucosa, genital and conjunctival or hepato-splenomegaly.


A strange rash with "gloves and socks" distribution.

Scaparrotta A, Rossi N, Attanasi M, Petrosino MI, Di Pillo S, Chiarelli F - Arch Med Sci (2015)

Erythema and edema of the hands with sharp demarcation at the level of the wrists of healthy skin
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4548047&req=5

Figure 0001: Erythema and edema of the hands with sharp demarcation at the level of the wrists of healthy skin
Mentions: On physical examination, the child showed erythematous and papular large itching lesions on the upper and lower limbs, characteristic of strophulus, and especially notable erythema and edema of the hands and feet, with a sharp demarcation at the level of the wrists and ankles of healthy skin (Figures 1 A and B). He did not show lesions of the oral mucosa, genital and conjunctival or hepato-splenomegaly.

View Article: PubMed Central - PubMed

Affiliation: Department of Pediatrics, "G. D'Annunzio" University, Chieti, Italy.

AUTOMATICALLY GENERATED EXCERPT
Please rate it.

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... On physical examination, the child showed erythematous and papular large itching lesions on the upper and lower limbs, characteristic of strophulus, and especially notable erythema and edema of the hands and feet, with a sharp demarcation at the level of the wrists and ankles of healthy skin (Figures 1 A and B)... He did not show lesions of the oral mucosa, genital and conjunctival or hepato-splenomegaly... Therefore, the diagnosis of PPGSS related to parvovirus B19 infection was made... There was also sporadic association with other viruses such as varicella zoster, EBV, CMV, HSV 6-7, Coxsackie, hepatitis B, and rubella... Prodromal or associated symptoms may be fever, asthenia, anorexia, arthralgia, myalgia, lymphadenopathy, lesions of the mucous membranes, and gastrointestinal symptoms... The symptomatic variety of PPGSS requires differential diagnosis with other rheumatologic and hematologic diseases: lymphoproliferative disorders, thrombocytopenic syndromes, Kawasaki disease, leukocytoclastic or hypersensitivity vasculitis (cryoglobulinemic vasculitis and Henoch-Schonlein purpura) and Still's disease... In most cases it needs only symptomatic treatment with antipyretics and non-steroidal anti-inflammatory drugs, avoiding the use of corticosteroids, because it is a self-limiting disease and immunosuppressive therapy may promote the persistence of the virus... Since the first description in 1990, about 90 cases of PPGSS have been described in the literature, with 74 items reported in PubMed for papular-purpuric gloves and socks syndrome, while only 34 items result when adding the filter of age (birth to 18 years)... Papular-purpuric gloves and socks syndrome, although rare in children, must be taken into account as an unusual clinical manifestation of infection by parvovirus B19, which differs from the fifth disease (or infectious erythema), the much more common disease caused by this virus in children, mainly by location, characteristics of the rash and accompanying symptoms... A correct diagnosis is important to avoid unnecessary laboratory tests and treatment.

No MeSH data available.


Related in: MedlinePlus