Question - What are the three stages that characterize the so-called “purple glove syndrome (PGS)”?
Answer- The cited review of PGS describes “…three temporal stages of injury: initial painful blue-purple discoloration and edema around the IV catheter site, subsequent worsening of pain, edema, and discoloration with development of epidermal sloughing, ulceration, or bullae formation, and neuromuscular symptoms such as paresthesias or weakness, and eventually resolution of edema and discoloration starting from the periphery of the injury and moving toward the site of catheter insertion. Timing of these stages appears quite variable, with initial discoloration occurring from minutes to days after phenytoin administration and tissue recovery spanning days to months.” (Garbovsky LA et al. Purple glove syndrome after phenytoin or fosphenytoin administration: Review of reported cases and recommendations for prevention. 2015 J Med Toxicol 11:445-459)