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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\u2010related antigens. A 32\u2010year\u2010old 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\u2010weave 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\u2010purpuric 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.<\/jats:p>","DOI":"10.1111\/cup.14213","type":"journal-article","created":{"date-parts":[[2022,2,11]],"date-time":"2022-02-11T17:33:53Z","timestamp":1644600833000},"page":"632-637","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["A rare case of papular\u2010purpuric \u201cgloves and socks\u201d syndrome associated with influenza"],"prefix":"10.1111","volume":"49","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7770-233X","authenticated-orcid":false,"given":"Brandon","family":"Zelman","sequence":"first","affiliation":[{"name":"Department of Pathology and Laboratory Medicine Loyola University Medical Center  Maywood Illinois USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aaron","family":"Muhlbauer","sequence":"additional","affiliation":[{"name":"Muhlbauer Dermatopathology Lab  Pittsford New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wendy","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Dermatology Loyola University Medical Center  Maywood Illinois USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0736-9076","authenticated-orcid":false,"given":"Jodi","family":"Speiser","sequence":"additional","affiliation":[{"name":"Department of Pathology and Laboratory Medicine Loyola University Medical Center  Maywood Illinois USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2022,3,6]]},"reference":[{"key":"e_1_2_5_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/0190\u20109622(90)70302\u2010x"},{"key":"e_1_2_5_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365\u20102133.2004.05946.x"},{"key":"e_1_2_5_4_1","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.01611\u201019"},{"key":"e_1_2_5_5_1","doi-asserted-by":"publisher","DOI":"10.1080\/14737159.2018.1503537"},{"key":"e_1_2_5_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/pde.14338"},{"key":"e_1_2_5_7_1","doi-asserted-by":"publisher","DOI":"10.1080\/030097400750001969"},{"key":"e_1_2_5_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/INF.0b013e31818cb289"},{"key":"e_1_2_5_9_1","doi-asserted-by":"publisher","DOI":"10.5114\/aoms.2015.53315"},{"key":"e_1_2_5_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140\u20106736(11)60554\u20100"},{"key":"e_1_2_5_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.0303\u20106987.2004.00186.x"},{"key":"e_1_2_5_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s001050050902"},{"key":"e_1_2_5_13_1","doi-asserted-by":"publisher","DOI":"10.1067\/mjd.2002.124612"},{"key":"e_1_2_5_14_1","doi-asserted-by":"publisher","DOI":"10.1001\/archderm.134.2.242"},{"key":"e_1_2_5_15_1","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.8725"},{"key":"e_1_2_5_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/ced.13013"},{"key":"e_1_2_5_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2004.11.040"},{"key":"e_1_2_5_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/0190\u20109622(92)70260\u2010m"},{"key":"e_1_2_5_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/s0190\u20109622(08)81924\u2010x"},{"issue":"5","key":"e_1_2_5_20_1","first-page":"335","article-title":"Petechial glove and sock syndrome caused by parvovirus B19","volume":"54","author":"Puig L","year":"1994","journal-title":"Cutis."},{"key":"e_1_2_5_21_1","first-page":"361","article-title":"\"Gloves and socks\" syndrome","volume":"5","author":"Morrell A","year":"1995","journal-title":"Eur J Dermatol."},{"key":"e_1_2_5_22_1","doi-asserted-by":"publisher","DOI":"10.1159\/000246563"},{"key":"e_1_2_5_23_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2133.1996.d01-1048.x"},{"key":"e_1_2_5_24_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365\u20104362.1996.tb03686.x"},{"key":"e_1_2_5_25_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1440\u20100960.1998.tb01261.x"},{"key":"e_1_2_5_26_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1525\u20101470.1998.1998015413.x"},{"key":"e_1_2_5_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/s0190\u20109622(99)70027\u20107"},{"key":"e_1_2_5_28_1","doi-asserted-by":"publisher","DOI":"10.1159\/000018333"},{"key":"e_1_2_5_29_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1346\u20108138.2002.tb00284.x"},{"key":"e_1_2_5_30_1","doi-asserted-by":"publisher","DOI":"10.1067\/mjd.2003.91"},{"key":"e_1_2_5_31_1","doi-asserted-by":"crossref","unstructured":"Sklavounou\u2010Andrikopoulou A Iakovou M Paikos S Papanikolaou V Loukeris D Voulgarelis M. 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