Bullous papular-purpuric gloves and socks syndrome in a 42-year-old female: Molecular detection of parvovirus B19 DNA in lesional skin

Frühauf, Julia; Massone, Cesare; Müllegger, Robert R.

doi:10.1016/j.jaad.2008.08.037

Cited by 23 publications

(30 citation statements)

References 26 publications

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“…4 The density of the lymphocytic infiltrate is quite variable from case to case, and focal vasculitic changes have also been described. 3,6 A causal role for PVB19 was first suggested by Bagot and Revuz, 2 who found IgM seroconversion in a single patient. This was partially confirmed in 1994 by Feldman et al, 15 who carried out serological studies in 10 cases and found in 3 of them a possible link to Parvovirus (2 cases as primary infection in children, 1 as a reactivation in an AIDS patient).…”

Section: Discussionmentioning

confidence: 95%

“…Other infectious agents possibly related to PPGSS include an array of viruses (Coxsackie B6, Human Herpes virus 6 and 7, Hepatitis B, Epstein-Barr, Cytomegalovirus, Measles, Rubella) and some bacterial infections (Arcanobacteriumhaemolyticum). 3 As of April of 2011, the number of PPGSS cases found performing a Pubmed search is under 100, and in more than 70% of them, specific IgM positivity in serum has been found. Demonstration of viral DNA in serum and/or skin biopsy samples has been carried out in a handful of reports as a means of linking PPGSS to PVB19 infection.…”

Section: Discussionmentioning

confidence: 99%

“…Subsequent case reports have stressed seroconversion (ie, IgM detection, followed by IgG) as a means of linking PVB19 to PPGSS. In all, less than 100 cases have been reported 3 and in more than 70% of them there has been serologic evidence of PVB19 infection.…”

Section: Introductionmentioning

confidence: 99%

“…Detection of viral DNA by polymerase chain reaction (PCR) in serum has been carried out in 10 previous cases, 3 and in only 5 has the presence of PVB19 DNA been investigated by PCR of skin biopsies. [4][5][6] A positive result by the former technique is regarded as proof of acute infection, but use of the latter has fallen into disfavor, because after infection in childhood the virus has the capacity to persist for a long time in human tissues 7 ; in a recent study, 25% of diverse skin samples harbored PVB19 DNA, 8 implying that the association between B19 infection and cutaneous disease should rely on markers other than the sole presence in the skin of viral DNA.…”

Section: Introductionmentioning

confidence: 99%

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Immunohistochemical Detection of Parvovirus B19 in “Gloves and Socks” Papular Purpuric Syndrome: Direct Evidence for Viral Endothelial Involvement. Report of Three Cases and Review of the Literature

Santonja

Nieto-González²,

Santos‐Briz³

et al. 2011

The American Journal of Dermatopathology

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Papular-purpuric "gloves and socks" syndrome is a distinctive dermatosis featuring acral pruritus, edema, and petechiae. It has been attributed in most--but not all--reported cases to Parvovirus B19 infection, on the grounds of serological proof of recent infection or detection of viral DNA by polymerase chain reaction in patient serum or biopsies. We report the immunohistochemical detection of Parvovirus B19 VP2 structural protein in the endothelial lining of dermal blood vessels in 3 examples of Papular-purpuric "gloves and socks" syndrome and review previously described immunohistochemical investigations in cutaneous involvement by this infection.

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Section: Discussionmentioning

confidence: 95%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Immunohistochemical Detection of Parvovirus B19 in “Gloves and Socks” Papular Purpuric Syndrome: Direct Evidence for Viral Endothelial Involvement. Report of Three Cases and Review of the Literature

Santonja

Nieto-González²,

Santos‐Briz³

et al. 2011

The American Journal of Dermatopathology

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“…180 Atypical variants include a unilateral distribution, 182 involvements of the buttocks, genital, and axillary regions, 183,184 and large haemorrhagic bullae progressing to cutaneous necrosis and skin ulcerations. 185–187 Post-morbid states are usually scar-free, 14 but thick black eschars have been reported. 185 …”

Section: Diagnostic Criteriamentioning

confidence: 99%

Gianotti-Crosti Syndrome, Pityriasis Rosea, Asymmetrical Periflexural Exanthem, Unilateral Mediothoracic Exanthem, Eruptive Pseudoangiomatosis and Papular-Purpuric Gloves and Socks Syndrome: A Brief Review and Arguments for Diagnostic Criteria

Chuh

Zawar²,

Law

et al. 2012

Infectious Disease Reports

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Several exanthems including Gianotti-Crosti syndrome, pityriasis rosea, asymmetrical periflexural exanthem, eruptive pseudoangiomatosis, and papular-purpuric gloves and socks syndrome are suspected to be caused by viruses. These viruses are potentially dangerous. Gianotti-Crosti syndrome is related to hepatitis B virus infection which is the commonest cause of hepatocellular carcinoma, and Epstein-Barr virus infection which is related to nasopharyngeal carcinoma. Pityriasis rosea has been suspected to be related to human herpesvirus 7 and 8 infections, with the significance of the former still largely unknown, and the latter being a known cause of Kaposi's sarcoma. Papular-purpuric gloves and socks syndrome is significantly associated with human B19 erythrovirus infection which can lead to aplastic anemia in individuals with congenital hemoglobinopathies, and when transmitted to pregnant women, can cause spontaneous abortions and congenital anomalies. With viral DNA sequence detection technologies, false positive results are common. We can no longer apply Koch's postulates to establish cause-effect relationships. Biological properties of some viruses including lifelong latent infection, asymptomatic shedding, and endogenous reactivation render virological results on various body tissues difficult to interpret. We might not be able to confirm or refute viral causes for these rashes in the near future. Owing to the relatively small number of patients, virological and epidemiology studies, and treatment trials usually recruit few study and control subjects. This leads to low statistical powers and thus results have little clinical significance. Moreover, studies with few patients are less likely to be accepted by mainstream dermatology journals, leading to publication bias. Aggregation of data by meta-analyses on many studies each with a small number of patients can theoretically elevate the power of the results. Techniques are also in place to compensate for publication bias. However, these are not currently feasible owing to different inclusion and exclusion criteria in clinical studies and treatment trials. The diagnoses of these rashes are based on clinical assessment. Investigations only serve to exclude important differential diagnoses. A wide spectrum of clinical features is seen, and clinical features can vary across different populations. The terminologies used to define these rashes are confusing, and even more so are the atypical forms and variants. Previously reported virological and epidemiological results for these rashes are conflicting in many aspects. The cause of such incongruence is unknown, but low homogeneity during diagnosis and subject recruitment might be one of the factors leading to these incongruent results. The establishment and proper validation of diagnostic criteria will facilitate clinical diagnosis, hasten recruitment into clinical studies, and allow results of different studies to be directly compared with each another. Meta-analyses and systematic reviews would be more valid. Diagn...

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Viral Infections

Sterling

2016

Rook's Textbook of Dermatology, Ninth Edition

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Bullous papular-purpuric gloves and socks syndrome in a 42-year-old female: Molecular detection of parvovirus B19 DNA in lesional skin

Cited by 23 publications

References 26 publications

Immunohistochemical Detection of Parvovirus B19 in “Gloves and Socks” Papular Purpuric Syndrome: Direct Evidence for Viral Endothelial Involvement. Report of Three Cases and Review of the Literature

Immunohistochemical Detection of Parvovirus B19 in “Gloves and Socks” Papular Purpuric Syndrome: Direct Evidence for Viral Endothelial Involvement. Report of Three Cases and Review of the Literature

Gianotti-Crosti Syndrome, Pityriasis Rosea, Asymmetrical Periflexural Exanthem, Unilateral Mediothoracic Exanthem, Eruptive Pseudoangiomatosis and Papular-Purpuric Gloves and Socks Syndrome: A Brief Review and Arguments for Diagnostic Criteria

Viral Infections

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