eMedicine Specialties > Pediatrics: General Medicine > Dermatology

Gianotti-Crosti Syndrome: Treatment & Medication

Author: Howard Pride, MD, Associate Professor, Departments of Pediatrics and Dermatology, Geisinger Medical Center
Contributor Information and Disclosures

Updated: Sep 29, 2008

Treatment

Medical Care

  • Gianotti-Crosti syndrome (GCS) is a benign self-limited condition that requires no treatment.
  • Topical steroids are generally not effective, although anecdotal responses have been reported.
  • Systemic treatment with antihistamines has been moderately helpful in relieving pruritus.

Consultations

  • Consultation with a dermatologist or a pediatric dermatologist should be sought in confusing cases.
  • Consultation with a pediatric gastroenterologist should be sought for the rare cases associated with the hepatitis B virus.

Activity

  • Activity is limited only by symptoms.
  • The infectious period ends when the exanthem appears; therefore, the patient may participate in daycare or school at this time.

Medication

No medical therapy is necessary. Topical corticosteroids and oral antihistamines might provide some symptomatic relief of pruritus.

Corticosteroids, topical cream

These agents may provide relief when pruritus is present.


Triamcinolone 0.1% cream (Aristocort)

Antipruritic effect of this cream is fairly marginal but may be somewhat effective. Treats inflammatory dermatosis that is responsive to steroids. Decreases inflammation by suppressing the migration of polymorphonuclear leukocytes and reversing capillary permeability.

Adult

Apply a thin film to affected areas bid prn

Pediatric

Apply as in adults

Documented hypersensitivity; fungal, viral, and bacterial skin infections

Pregnancy

C - Fetal risk revealed in studies in animals but not established or not studied in humans; may use if benefits outweigh risk to fetus

Precautions

Excessive use of topical steroids may cause skin atrophy; do not use in decreased skin circulation; potential for systemic absorption and adrenal suppression when used over large surface areas in young children

Antihistamines

These agents may provide some relief when pruritus is present. They are used to treat minor allergic reactions and anaphylaxis and may be used to pretreat patients with prior documentation of minor allergic reactions. These agents may control itching by blocking effects of endogenously released histamine.


Hydroxyzine (Atarax, Vistaril)

Offers a mild degree of relief from pruritus. Antagonizes H1 receptors in periphery. May suppress histamine activity in the subcortical region of CNS.

Adult

25-50 mg PO q6h prn

Pediatric

1 mg/kg/dose PO q6h prn

May potentiate the effect of opioid analgesics, barbiturates, alcohol, or other CNS depressants

Documented hypersensitivity; early pregnancy

Pregnancy

C - Fetal risk revealed in studies in animals but not established or not studied in humans; may use if benefits outweigh risk to fetus

Precautions

Associated with clinical exacerbations of porphyria (may not be safe for patients with porphyria); ECG abnormalities (alterations in T waves) may occur; causes drowsiness

More on Gianotti-Crosti Syndrome

Overview: Gianotti-Crosti Syndrome
Differential Diagnoses & Workup: Gianotti-Crosti Syndrome
Treatment & Medication: Gianotti-Crosti Syndrome
Follow-up: Gianotti-Crosti Syndrome
Multimedia: Gianotti-Crosti Syndrome
References
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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. 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].

  4. 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].

  5. 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].

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

  7. 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].

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

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

  10. 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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Further Reading

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Keywords

Gianotti-Crosti syndrome, GCS, papular acrodermatitis of childhood, papulovesicular acrolocated syndrome, hepatitis B infection, hepatitis B, lymphadenopathy, rash Epstein-Barr virus, papular acrodermatitis, hepatosplenomegaly, inguinal adenopathy, rotavirus, cytomegalovirus, adenovirus, enterovirus, respiratory syncytial virus, parainfluenza virus, Parvovirus, paravaccinia, human herpesvirus 6, echovirus, molluscum contagiosum, human immunodeficiency virus, HIV, group A beta-hemolytic streptococci, Mycobacterium avium-intracellulare, Mycoplasma pneumoniae, Bartonella henselae, Borrelia burgdorferi, meningococcemia, polio, diphtheria, influenza, pertussis, measles, smallpox, hepatitis A

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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.

Medical Editor

Kevin P Connelly, DO, Clinical Assistant Professor, Department of Pediatrics, Division of General Pediatrics and Emergency Care, Virginia Commonwealth University; 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.

Pharmacy Editor

Mary L Windle, PharmD, Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy, Pharmacy Editor, eMedicine
Disclosure: Pfizer Inc Stock Investment from broker recommendation; Avanir Pharma Stock Investment from broker recommendation

Managing Editor

Robert A Schwartz, MD, MPH, Professor and Head of Dermatology, Professor of Medicine, Professor of Pediatrics, Professor of Pathology, Professor of Preventive Medicine and Community Health, UMDNJ-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.

CME Editor

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 Lawson-Wilkins Pediatric Endocrine Society
Disclosure: Nothing to disclose.

Chief Editor

Dirk M Elston, MD, Director, Department of Dermatology, Geisinger Medical Center
Dirk M Elston, MD is a member of the following medical societies: American Academy of Dermatology
Disclosure: Nothing to disclose.

 
 
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