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Gianotti-Crosti syndrome in Child
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Gianotti-Crosti syndrome in Child

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Contributors: Sophia Delano MD, Craig N. Burkhart MD, Dean Morrell MD, Susan Burgin MD
Other Resources UpToDate PubMed

Synopsis

Gianotti-Crosti syndrome (papular acrodermatitis of childhood, papulovesicular acrolated syndrome) is a self-limiting dermatosis likely triggered by viral infection.

The eruption of Gianotti-Crosti syndrome typically lasts 3-4 weeks and is usually seen in preschool children but can be seen in children aged up to 13 years with rare case reports in adults. It is most commonly diagnosed in children aged 6 months to 14 years. The lesions can last up to 8 weeks before resolving spontaneously. A 2016 study found that children with atopic dermatitis or other manifestations of atopy were at greater risk for Gianotti-Crosti.

Agents thought to be responsible for the typical eruption include hepatitis B virus, hepatitis A and C viruses, cytomegalovirus (CMV), Epstein-Barr virus (EBV), enteroviruses, rotavirus, respiratory syncytial virus, parvovirus B19, vaccinia virus, rubella virus, human immunodeficiency virus (HIV)-1, and parainfluenza virus. The syndrome has also been observed following immunizations against poliovirus, diphtheria, pertussis, Japanese encephalitis, influenza, and hepatitis B virus and measles (together). The clinical features of the syndrome are identical, independent of the triggering agent.

With widespread immunization, most cases of Gianotti-Crosti syndrome seen in the United States, Canada, Europe, and India are not associated with hepatitis B virus infection. EBV is by far the most common cause in the United States.

Codes

ICD10CM:
L44.4 – Infantile papular acrodermatitis [Gianotti-Crosti]

SNOMEDCT:
82721003 – Gianotti-Crosti syndrome

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Differential Diagnosis & Pitfalls

  • Viral exanthema
  • Papular urticaria, a persistent pruritic papular eruption that can be triggered by arthropod bites. Individual lesions last longer than 24 hours unlike true urticaria.
  • Erythema multiforme presents with nonblanching targetoid lesions, often best seen on the palms and soles. Patient may have co-existing herpes orolabialis or mycoplasma infection.
  • Immunoglobulin A vasculitis (formerly Henoch-Schönlein purpura) presents with palpable purpura on the legs, arms, and buttocks with associated abdominal pain and arthritis.
  • Lichen planus typically presents with pruritic, flat-topped, polygonal, violaceous papules on the volar wrists and ankles. Mucosal and nail findings frequently aid in the clinical diagnosis.
  • Molluscum contagiosum may mimic the papules of Gianotti-Crosti. Noninflamed molluscum will present as pink or flesh-colored dome-shaped papules with central umbilication. Molluscum lesions favor the groin and axillae, as well as antecubital and popliteal fossae.
  • A detailed history is helpful in distinguishing this entity from a drug eruption.
  • Id reaction (autoeczematization) secondary to a primary severe inflammatory dermatosis elsewhere (allergic contact dermatitis, atopic dermatitis, dermatophytosis, bacterial infection).
  • Hand-foot-and-mouth disease – Papulovesicles may extend up the extremities in more severe cases.

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Last Reviewed: 03/16/2017
Last Updated: 12/14/2018
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Gianotti-Crosti syndrome in Child
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Gianotti-Crosti syndrome : Buttocks, Erythema, Extensor distribution, Face, Smooth papules
Clinical image of Gianotti-Crosti syndrome
Multiple erythematous and edematous papules and plaques on the leg.
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