Gianotti-Crosti Syndrome Clinical Presentation

  • Author: Howard Pride, MD; Chief Editor: Dirk M Elston, MD   more...
 
Updated: Mar 30, 2012
 

History

The rash of Gianotti-Crosti syndrome (GCS) usually has sudden onset and may be associated with an acute infectious illness or immunization. The rash is usually present for 2-4 weeks but can last as long as 4 months. It may be mildly pruritic. Recurrent episodes have been rarely reported.[3]

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Physical

  • Children with GCS generally appear healthy; however, the following may occur:
    • Multiple papules erupt on the face, buttocks, and extensor surface of the extremities; papules are symmetrically distributed, discrete, and flesh-toned–to–erythematous-to-brown and flat-topped. Multiple erythematous flat-topped papules on the cMultiple erythematous flat-topped papules on the cheeks of an 18-month-old boy with Gianotti-Crosti syndrome. Arm of a 3-year-old boy with Gianotti-Crosti syndrArm of a 3-year-old boy with Gianotti-Crosti syndrome demonstrating well-defined erythematous lichenoid papules on the arm and forearm. Thigh of the 3-year-old boy with Gianotti-Crosti sThigh of the 3-year-old boy with Gianotti-Crosti syndrome.
    • The trunk is strikingly spared, although a transient eruption can occur.
    • Individual papules are monomorphous and range in size from 1-5 mm. They may be hemorrhagic or edematous to the point of forming vesicles. They may coalesce into larger plaques.
    • The face may be the only area of involvement. One report that highlighted this clinical presentation showed that all children with an exclusively facial eruption had Epstein-Barr virus.[4]
  • Hepatosplenomegaly and axillary or inguinal adenopathy are inconsistent findings.
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Causes

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Contributor Information and Disclosures
Author

Howard Pride, MD  Associate Professor, Departments of Pediatrics and Dermatology, Geisinger Medical Center

Howard Pride, MD is a member of the following medical societies: American Academy of Dermatology and Society for Pediatric Dermatology

Disclosure: Nothing to disclose.

Specialty Editor Board

Kevin P Connelly, DO  Clinical Assistant Professor, Department of Pediatrics, Division of General Pediatrics and Emergency Care, Virginia Commonwealth University School of Medicine; Medical Director, Paws for Health Pet Visitation Program of the Richmond SPCA; Pediatric Emergency Physician, Emergency Consultants Inc, Chippenham Medical Center

Kevin P Connelly, DO is a member of the following medical societies: American Academy of Pediatrics, American College of Osteopathic Pediatricians, and American Osteopathic Association

Disclosure: Nothing to disclose.

Mary L Windle, PharmD  Adjunct Associate Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Nothing to disclose.

Robert A Schwartz, MD, MPH  Professor and Head, Dermatology, Professor of Pathology, Pediatrics, Medicine, and Preventive Medicine and Community Health, University of Medicine and Dentistry of New Jersey-New Jersey Medical School

Robert A Schwartz, MD, MPH is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American College of Physicians, and Sigma Xi

Disclosure: Nothing to disclose.

Merrily P M Poth, MD  Professor, Department of Pediatrics and Neuroscience, Uniformed Services University of the Health Sciences

Merrily P M Poth, MD is a member of the following medical societies: American Academy of Pediatrics, Endocrine Society, and Pediatric Endocrine Society

Disclosure: Nothing to disclose.

Chief Editor

Dirk M Elston, MD  Director, Ackerman Academy of Dermatopathology, New York

Dirk M Elston, MD is a member of the following medical societies: American Academy of Dermatology

Disclosure: Nothing to disclose.

References

  1. Baleviciene G, Maciuleviciene R, Schwartz RA. Papular acrodermatitis of childhood: the Gianotti-Crosti syndrome. Cutis. Apr 2001;67(4):291-4. [Medline].

  2. Caputo R, Gelmetti C, Ermacora E, et al. Gianotti-Crosti syndrome: a retrospective analysis of 308 cases. J Am Acad Dermatol. Feb 1992;26(2 Pt 1):207-10. [Medline].

  3. Metelitsa AI, Fiorillo L. Recurrent Gianotti-Crosti syndrome. J Am Acad Dermatol. Oct 2011;65(4):876-7. [Medline].

  4. Yoshida M, Tsuda N, Morihata T, et al. Five patients with localized facial eruptions associated with Gianotti-Crosti syndrome caused by primary Epstein-Barr virus infection. J Pediatr. Dec 2004;145(6):843-4. [Medline].

  5. Mendoza N, Diamantis M, Arora A, et al. Mucocutaneous manifestations of Epstein-Barr virus infection. Am J Clin Dermatol. 2008;9(5):295-305. [Medline].

  6. Draelos ZK, Hansen RC, James WD. Gianotti-Crosti syndrome associated with infections other than hepatitis B. JAMA. Nov 7 1986;256(17):2386-8. [Medline].

  7. Atanasovski M, Dele-Michael A, Dasgeb B, Ganger L, Mehregan D. A case report of Gianotti-Crosti post vaccination with MMR and dTaP. Int J Dermatol. May 2011;50(5):609-10. [Medline].

  8. Kroeskop A, Lewis AB, Barril FA, Baribault KE. Gianotti-Crosti syndrome after H1N1-influenza vaccine. Pediatr Dermatol. Sep-Oct 2011;28(5):595-6. [Medline].

  9. Brandt O, Abeck D, Gianotti R, Burgdorf W. Gianotti-Crosti syndrome. J Am Acad Dermatol. 2006;54:136-145. [Medline].

  10. Chuh A, Lee A, Zawar V. The diagnostic criteria of Gianotti-Crosti syndrome: are they applicable to children in India?. Pediatr Dermatol. Sep-Oct 2004;21(5):542-7. [Medline].

  11. Chuh AA. Diagnostic criteria for Gianotti-Crosti syndrome: a prospective case-control study for validity assessment. Cutis. Sep 2001;68(3):207-13. [Medline].

  12. Magyarlaki M, Drobnitsch I, Schneider I. Papular acrodermatitis of childhood (Gianotti-Crosti disease). Pediatr Dermatol. Sep 1991;8(3):224-7. [Medline].

  13. Taieb A, Plantin P, Du Pasquier P, et al. Gianotti-Crosti syndrome: a study of 26 cases. Br J Dermatol. Jul 1986;115(1):49-59. [Medline].

 
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Multiple erythematous flat-topped papules on the cheeks of an 18-month-old boy with Gianotti-Crosti syndrome.
Arm of a 3-year-old boy with Gianotti-Crosti syndrome demonstrating well-defined erythematous lichenoid papules on the arm and forearm.
Thigh of the 3-year-old boy with Gianotti-Crosti syndrome.
 
 
 
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