Drug-induced papular-purpuric gloves and socks syndrome

Abstract

The papular-purpuric "gloves and socks" syndrome (PPGSS) was first described in 1990 by Harms et al. The syndrome is characterised by fever, an itchy erythema with edema, confluent papules and purpura of the hands and feet in a "gloves and socks" distribution. The skin lesions may be associated with purpura and superficial erosions of the oral mucosa. Viral infections, in particular parvovirus B19, are the most likely trigger. In the present case PPGSS developed after taking trimethoprim/sulfamethoxazole. Since the patient developed identical symptoms after accidental re-challenge with the same drug, this case strongly suggests medications as another factor in the pathogenesis of PPGSS.