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A 20 year old girl presented with a rash that she had for 6 days. she is in good health until the rescent rash that was accompanied by mild fever and malaise. she also reported swelling in her lips that faded in a day, but no other swelling or itching in the body. after the swelling she developed a rash in both her palms and soles which is occasionally itchy. she also complained of some discomfort in her mouth when eating. she believes that all her symptoms are from eating Tuna and sea food, which preceded the lip swelling.
on examinatn she has multiple purpric macules over both her palms and soles and ptechiae in her hard palate. se also has a (white tongue). rest of the exaimation is normal.
so the question is what is this rash?
whats the best line of management?
there will be a discussion at the end of this week
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dermlive
dermis111
dr660
skindr
visitor111
epiderma
kamalsaleh
it looks like vasculitis, i would do the necessary workup to rule out infections (like HBV B), immunological (ANA) and do Kindney function test, it ooks mild i will only prescribe mid potency topical steroid,
for the oral lesions , they might be an incedintal oral thrush.
so whats the lab results?
we believe this is of a Papular-Purpuric Glove-and-Sock Syndrome , a rare, infectious disease, of viral etiology, characterized by the presence
of pruritus, edema and symmetrical erythema, very well defined at the wrists and ankles with a gloves-and-socks distribution.
Other areas can be affected, with a moderate erythema appearing in cheeks, elbows, knees, armpits, abdomen,
groin, external genitalia, internal face of the thighs and the buttocks. Erosions, small ulcers, enanthema and blisters
can be observed in the oral cavity and lips, and less frequently in other mucous membranes. Complications are rare,
although they can be severe, 50% of the published cases are related with the Parvovirus B19.
this patient had the petechiae in the palate along with the characterstic rash. she was planning to travel with a pregnant lady, and luckily we advised her not to. parvovirus B19 is known to cause hydrops fetalis in non immune pregnant ladies esepcially early in the pregnancy.
she was seen two weeks later with with her rash clearing and only a faint post inflammatory hyperpigmentation