Papular-purpuric gloves and socks syndrome due to parvovirus B19: a report of two simultaneous cases in cohabitant families.

The so-called papular-purpuric gloves and socks syndrome (PPGSS) is a condition characterized by acute onset of intense erythema, edema and petechiae with a typical localization on the hands and feet, besides mucosal lesions of the oral cavity. The syndrome has a favorable and self-limited course, requiring only a symptomatic therapy. In the 50% of the cases described in literature (ninety cases in 22 years), is documented an acute infection caused by parvovirus B19 and in only two cases the onset of PPGSS is reported among different members of the same family. The aim of the work is to describe two cases of PPGSS arisen during a short time period in two family members affected by an acute parvovirus B19 infection found by serum sampling. The peculiarity of the study was the infrequence of the syndrome and the rareness of the description of PPGSS in rheumatology. This syndrome is usually described in dermatology, but it is also interesting for the rheumatologist because it comes in differential diagnosis with various autoimmune diseases.

Body mass does not affect the remission of psoriatic arthritis patients on anti-TNF-α therapy.

OBJECTIVES: There is evidence that fat tissue may influence the response to therapy in patients with arthritis. The aim of this study was to assess whether the body mass index (BMI) affects rates of clinical remission in patients with psoriatic arthritis (PsA) treated with anti-tumour necrosis factor (TNF)-α biological drugs. METHOD: We retrospectively studied 135 patients with active peripheral PsA (45 obese, 47 overweight, and 43 normal-weight). Baseline BMI was correlated with the clinical response to adalimumab, etanercept, or infliximab. After 36 months (median, range 6-79) of treatment, disease remission rates were assessed using the Disease Activity Score in 28 joints (DAS28) or the Simplified Disease Activity Index (SDAI). Possible predictors of clinical outcomes were assessed by multivariate analysis. RESULTS: At baseline, BMI was significantly correlated only with the Health Assessment Questionnaire (HAQ) score (r = 0.21, p = 0.02) and not with disease activity. BMI did not predict disease remission or changes in HAQ score following anti-TNF-α therapy. Obese patients showed a significantly higher HAQ score and took significantly lower doses of prednisone than normal-weight or overweight patients, but their disease remission rates on the DAS28 (37%) or the SDAI (21%) were not significantly different from those of the other two groups (44% and 21%, respectively), regardless of the TNF-α inhibitor prescribed. CONCLUSIONS: In our retrospective analysis, disease activity and clinical response to anti-TNF-α therapy in PsA do not seem to be affected by BMI. Further prospective studies are needed to confirm these preliminary results.