Papular–Purpuric “Gloves and Socks” Syndrome in Parvovirus B19 Infection
A 26-year-old man presented to the dermatology clinic with a 1-week history of an asymptomatic rash on his hands and feet. He also reported having had a fever — which had resolved 6 days before presentation — but no joint pains or oral lesions. Physical examination was notable for scattered, partially blanchable macules around the wrists and ankles that merged into erythematous patches on the ventral (Panels A and B) and dorsal (Panels C and D) surfaces of the hands and feet. No skin changes were observed on the cheeks or elsewhere. A serum B19 IgM antibody test and a polymerase-chain-reaction assay were positive for parvovirus. A diagnosis of papular–purpuric “gloves and socks” syndrome in the context of parvovirus B19 infection was made. The classic rash associated with parvovirus B19 infection is a “slapped cheek” pattern on the face, but other distributions of rashes may be seen. The acral rash seen in papular–purpuric “gloves and socks” syndrome most commonly manifests in adolescents and adults. Despite the name of the syndrome, the skin lesions may be petechial or macular. The patient was reassured about the self-limited nature of the viral infection. One week later, the rash had abated.