Simultaneous Infection by Human Herpesvirus 7 and Human Parvovirus B19 in Papular-Purpuric Gloves-and-Socks Syndrome

Ongrádi, J; Becker, Krisztina; Horváth, Attila; Hidvégi, Edit; Mezey, I

doi:10.1001/archderm.136.5.672

Cited by 27 publications

(16 citation statements)

References 5 publications

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“…The term PPGSS is used whether it is related to HB19EV, 53–55 other viruses, 56–59,139,140 or other causes such as drugs. 141 The nomenclature does not change when PPGSS coexists with other cutaneous diseases 142 or in immunocompromised patients.…”

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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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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show abstract

“…The pathogenetic pattern and subsequent clinical presentation may be the result a complex interplay of the host's humoral and/or cellular response, viral load, and even coinfection with another virus, such as human herpesviruse6. 11 Our patient had a generalized petechial eruption with prominent involvement of the upper lip and the distal extremities. We believe that our case does not fit into either PPGSS or the newly described acropetechial syndrome, because of its widespread involvement.…”

Section: Discussionmentioning

confidence: 72%

“…Our case and the reviewed literature highlight the protean manifestations of parvovirus infection. Testing for parvovirus infection should be considered in the initial workup of any patient Lefrere 12 Palpable purpura HSP 6 C Conway 13 Petechiae 4 A, C Family of 4 Schwarz 14 Purpura Vasculitis 3 C Harms 5 Purpura PPGSS 7 A Veraldi 15 Purpura HSP 1 C Fergusson 16 Purpura HSP 3 C 3/27 were linked to Parvovirus Saulsbury 17 Purpura PPGSS 1 C Smith 18 Purpura PPGSS 1 A Abuhammour 19 Purpura PPGSS 1 C Drago 20 Purpura, hepatitis Unilateral exanthem 1 A Martinez 21 Purpura PPGSS 1 A Hakim 22 Purpura PPGSS 1 C HSP Ongradi 11 Purpura PPGSS 1 C Cioc 23 Purpura HSP 1 A Harel 10 Petechiae Acro-petechial syndrome 3 C Messina 24 Petechiae PPGSS 1 C Alfadley 25 Palpable purpura PPGSS 2 A, C Sklavounou-Andrikopoulou 7 Purpura PPGSS 1 A Palatal petechiae A, Adults; C, children; HSP, Henoch Schonlein purpura; PPGSS, papular-purpuric gloves and socks syndrome. J AM ACAD DERMATOL VOLUME 52, NUMBER 5 presenting with a petechial/purpuric eruption of unclear origin.…”

Section: Discussionmentioning

confidence: 99%

Generalized petechial eruption induced by parvovirus B19 infection

McNeely

Friedman

Pope

2005

Journal of the American Academy of Dermatology

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“…Before long, erythematopapular and purpuric lesions evolve in the same sites. Oral lesions 4,9,10,13,14 and constitutional symptoms usually accompany the eruption of the purpuric rash. In many cases, there is mild anemia, reticulocytopenia, leucopenia, and thrombocytopenia.…”

Section: Discussionmentioning

confidence: 99%