Gianotti-Crosti Syndrome

Aetiology and epidemiology

Table 1: Viruses and bacteria associated with Gianotti-Crosti syndrome
Viral Epstein Barr virus
Hepatitis A, B, C
Human herpesvirus 6
Coxsackie A16, B4, B5
Parvovirus B19
Parvovirus B19
Bacterial Bartonella henselae
Beta-haemolytic streptococci
Borrelia burgdorferi
Mycoplasma pneumonia

Gianotti-Crosti syndrome is a papular acrodermatitis. It is a self-limiting illness peaking between 1 and 6 years of age and is associated with a range of viruses and bacteria (Table 1).

Clinical assessment

Symptoms of Gianotti-Crosti syndrome include:
1. Low-grade fever
2. Diarrhoea
3. Tonsillitis
4. Lymphadenopathy

Children with atopic dermatitis are more often affected and an association with immunisation is recognised.

The rash is characteristically papular or papulovesicular in form and symmetrically distributed on the face, buttocks and the upper and lower extensor surface of the extremities. The trunk, however, is usually spared. Lesions can last from 5 days up to 12 months, although most heal within 2 months.

Image reproduced with permission from Medscape. Article: Dermatologic Manifestations of Gianotti-Crosti Syndrome.


Investigations of Gianotti-Crosti syndrome are rarely indicated unless there is diagnostic uncertainty or presence of physical findings, e.g. hepatomegaly.


Further management of Gianotti-Crosti patients is rarely indicated unless there is diagnostic uncertainty or atypical presentation. Under these circumstances, follow-up is indicated.

Antihistamines may be needed with some patients for treatment of pruritus.


Complications of Gianotti-Crosti syndrome are rare but can include chronic liver disease secondary to hepatitis B infection.