Drug-induced papular-purpuric "gloves and socks" syndrome

The papular-purpuric "gloves and socks" syndrome (PPGSS) was first describe d 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, a re the most likely trigger. In the present cas e PPGSS developed after taking trimethoprim/sulfamethoxazole. Since the pat ient developed identical symptoms after accidental re-challenge with the sa me drug, this case strongly suggests medications as another factor in the p athogenesis of PPGSS.