Papular-purpuric gloves and socks syndrome associated with B19V infection in a 6-year-old child

• Published in: Journal of clinical virology Vol. 44; no. 2; pp. 167 - 169
• Main Authors: Parez, Nathalie, Dehée, Axelle, Michel, Yanne, Veinberg, Frédérique, Garbarg-Chenon, Antoine
• Format: Journal Article
• Language: English
• Published: Amsterdam Elsevier B.V 01.02.2009; Elsevier
• Subjects: Acral dermatosis; Allergy and Immunology; Antibodies, Viral - blood; Biological and medical sciences; Child; Children; DNA, Viral - blood; Erythema Infectiosum - diagnosis; Erythema Infectiosum - pathology; Erythema Infectiosum - physiopathology; Female; Fundamental and applied biological sciences. Psychology; Human viral diseases; Humans; Immunoglobulin G - blood; Immunoglobulin M - blood; Infectious Disease; Infectious diseases; Medical sciences; Microbiology; Miscellaneous; Papular-purpuric gloves and socks syndrome; Parvovirus B19; Parvovirus B19, Human - isolation & purification; Viral diseases; Viral Load; Virology; papular-purpuric gloves and socks syndrome; human herpesvirus 6; HHV6; B19V; PPGSS; Children; Acral dermatosis; parvovirus B19; PCR; polymerase chain reaction; Parvovirus B19; Papular-purpuric gloves and socks syndrome; Human; Skin disease; Microbiology; Cardiovascular disease; Erythrovirus; Virus B19; Virology; Vascular disease; Virus; Gloves and socks syndrome; Parvoviridae; Purpura; Capillary vessel disease; Child; Parvovirinae
• ISSN: 1386-6532; 1873-5967
• DOI: 10.1016/j.jcv.2008.11.013

Abstract A 6 year-old girl was admitted for evaluation of a fever associated with a petechial rash of 2 days’ duration. She was in good general condition with no acute distress. Inspection of the skin revealed an amazing papular and purpuric rash of predominantly acral and symmetrical distribution and sharply demarcated on the ankles. All laboratory tests were found normal. Rash and fever completely resolved in less than 3 days. Serological testing for parvovirus B19 (B19V) antibodies was positive for IgM but negative for IgG. Moreover, B19V DNA was detected in serum with a viral load of 2.24 × 108 copies per mL. So we concluded of a paediatric case of popular-purpuric gloves and socks syndrome (PPGSS) associated with B19V infection. PPGSS is an idiosyncratic reaction to viral infection. The syndrome has been associated with several viruses such as HHV6, measles, coxsackie B6, and above all B19V. PPGSS occurs mostly in young adults. It is characterised by a typical papular and purpuric rash with an acral distribution and a sharp demarcation on the wrists and ankles. The rash is often pruritic and can be accompanied by mucosal lesions and/or systemic symptoms such as fever, asthenia and lymphadenopathy. Most of the time, the disease is self-limited with a short course and a benign prognosis. A very similar disease has been described in some children. The distinctive clinical characteristics of PPGSS in children should be recognized by paediatrician in particular at the emergency room in order to avoid superfluous explorations.