www.jpeds.com • THE JOURNAL OF PEDIATRICS INSIGHTS AND IMAGES Papular Purpuric Gloves and Socks Syndrome because of a Mycoplasma Infection 3-year-old girl presented to our clinic with mild, nonpruritic, palmar and plantar erythematous papules, A and a few erythematous lesions on the oral mucosa. The lesions appeared 2-3 days before presentation and besides low-grade fever, physical examination was unremarkable. Vac- cination history was according to national immunization sched- ules. The clinical picture was most compatible with hand- foot-and-mouth disease (most common cause coxsackievirus A16), and the child was sent home without treatment. On day 5, the lesions on the hands and feet evolved to painful con- ﬂuent purpuric lesions (Figure 1; available at www.jpeds.com), and she presented to the emergency department of our hos- pital. Because no fever or other systemic systems were present, she was discharged with supportive therapy. The following day, the purpuric lesions increased in size (Figure 2; avail- able at www.jpeds.com) and she returned to the emergency department. Inﬂammatory markers were slightly elevated Figure 3. Day 12: bullae on the hands (recovery phase). (C-reactive protein 28 mg/L, white blood cell count 18 × 10.9/L), with normal thrombocytes and coagulation. To prevent more inﬂammation, nonsteroidal anti-inﬂammatory
The Journal of Pediatrics – Elsevier
Published: Mar 1, 2018
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