丘疹性紫癜“手套和袜子”综合征(PPGSS)是一种独特的,以水肿为特征的自限性皮肤病,红斑,和瘙痒的瘀点和丘疹在一个独特的“手套和袜子”分布。这通常伴有全身症状,包括发烧,淋巴结病,虚弱,肌痛,和Arthralgias.PPGSS也已被描述为可由病毒或药物相关抗原触发的潜在免疫机制的表现。一名32岁的男性在被诊断为乙型流感后,双侧手脚出现疼痛性爆发,经检查,双侧手部可见散见性丘疹性紫癜,偶有覆垢,手指,脚,脚趾,掌侧手腕,和脚踝。组织病理学切片显示炎症与界面和海绵状变化的混合模式。还观察到带有覆盖篮状组织的角化角化角的角化缺损。在表皮内,表皮内囊泡和朗格汉斯细胞微脓肿形成,并有分散的凋亡角质形成细胞。下面的真皮显示浅表血管周围淋巴细胞浸润伴轻度水肿改变,红细胞外渗.临床病理相关性强烈支持对流行的紫癜性手套和袜子综合征的诊断。从未报道过与PPGSS相关的流感病毒;因此,该病例概述了临床医生应该熟悉的重要新变种.
Papular-purpuric \"gloves and socks\" syndrome (PPGSS) is a unique, self-limited dermatosis characterized by edema, erythema, and pruritic petechiae and papules in a distinct \"gloves and socks\" distribution. This is often accompanied by systemic symptoms, including fever, lymphadenopathy, asthenia, myalgia, and arthralgias. PPGSS has also been described as a manifestation of an underlying immunological mechanism that can be triggered by viral or drug-related antigens. A 32-year-old male developed a painful eruption on the bilateral hands and feet after being diagnosed with influenza B. On examination, scattered papular purpura with occasional overlying scale was noted on the bilateral hands, fingers, feet, toes, volar wrists, and ankles. Histopathologic sections showed a mixed pattern of inflammation with interface and spongiotic changes. A parakeratotic scale with overlying basket-weave orthokeratosis was also seen. Within the epidermis, there was intraepidermal vesicles and Langerhans cell microabscess formation with scattered apoptotic keratinocytes. The underlying dermis showed a superficial perivascular lymphocytic infiltrate with mild edematous changes, and extravasation of red blood cells. Clinicopathologic correlation strongly supported a diagnosis of popular-purpuric gloves and socks syndrome. The influenza virus has never been reported in association with PPGSS; thus, this
case outlines an important new variant that clinicians should be familiar with.