Papular-purpuric "gloves and socks" syndrome: Polymerase chain reaction demonstration of parvovirus B19 DNA in cutaneous lesions and sera

We report a typical case of papular-purpuric "gloves and socks" syndrome (P PGSS) in which primary infection lay parvovirus B19 was demonstrated by ser oconversion to this virus; parvovirus B19 DNA was also identified by polyme rase chain reaction (PCR) methods in the sera of the patient and in the cut aneous biopsy specimen, both taken 4 days after the onset of clinical manif estations. To our knowledge, this is the fourth published case in which par vovirus B19 DNA has been recovered from the skin by PCR. Serologic studies and PCR investigations in cutaneous biopsy for other viruses including herp es simplex virus types 1 and 2, varicella tester virus, Epstein-Barr virus, cytomegalovirus, and human herpesvirus 6, 7, and 8 were negative. Clinical ly our case presented some additional features, which have not been previou sly described in cases of PPGSS, namely dysuria with vulvar edema and eryth ema, and unilateral petechial rash on the breast. The histopathologic findi ngs of our case were nonspecific and consisted of an interface dermatitis w ith slight vacuolar degeneration at the dermoepidermal junction and a super ficial perivascular inflammatory infiltrate mostly composed of lymphocytes, with numerous extravasated erythrocytes. We review the cases of PPGSS publ ished in the literature with respect to the different viruses that have bee n proposed as etiologic agents and conclude that acute infection by parvovi rus B19 is the only one that has been adequately proved.