Gianotti-Crosti Syndrome
Aetiology and epidemiology
| Viral | Epstein Barr virus |
| Hepatitis A, B, C | |
| Cytomegalovirus | |
| Human herpesvirus 6 | |
| Coxsackie A16, B4, B5 | |
| Rotavirus | |
| 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
Investigations of Gianotti-Crosti syndrome are rarely indicated unless there is diagnostic uncertainty or presence of physical findings, e.g. hepatomegaly.
Management
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
Complications of Gianotti-Crosti syndrome are rare but can include chronic liver disease secondary to hepatitis B infection.