A case report of papular-purpuric gloves and socks syndrome: A manifestation of the parvovirus B19

Abstract

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 drugs or vaccines against parvovirus. Patients with PPGSS require only symptomatic therapy. Case Report: We report the case of a 30-year-old female with this characteristic erythema caused by the parvovirus B19. Nevertheless, this case is remarkable because the patient had significant systemic manifestations and an exuberant perineal and oropharyngeal involvement. Further, the erythema assumed a bullous expression that has not been so commonly reported. A biopsy was performed which was unspecific and the diagnosis was confirmed with the serology and molecular detection of the virus in blood sample as well as on mouth swab. Our patient needed treatment to control pain and pruritus, fever was self-limited. Conclusion: A high index of suspicion is essential to diagnose patients with this syndrome. Early recognition can prevent unproductive measures and the good management of this infection.