Gianotti-Crosti syndrome (GCS), also known as papular acrodermatitis, papular acrodermatitis of childhood, and infantile papular acrodermatitis, is a symmetric papular eruption with an acral distribution (cheeks, buttocks, and extensor surfaces of the forearms and legs) (picture 1A-B). It was first described by Gianotti in 1955, and by Crosti and Gianotti in 1957 [1,2], and was initially believed to occur only in infants and children [3-5]. It has since been reported in adults [6-8].
In the original descriptions, GCS had three cardinal manifestations [1-5]:
- Nonrelapsing erythemato-papular dermatitis localized to the face and limbs, lasting about three weeks
- Paracortical hyperplasia of lymph nodes
- Acute hepatitis, usually anicteric, which could last for months and progress to chronic liver disease
Gianotti referred to papular or papulovesicular acral eruptions, with or without itching, associated with reactive lymphadenitis, but not hepatitis, as "papulovesicular acrolocated syndrome" . However, it is not possible to distinguish between GCS and papulovesicular acrolocated syndrome solely on the basis of cutaneous findings .
With current terminology, neither lymphadenopathy nor hepatitis is mandatory for the diagnosis of GCS. The term "Gianotti-Crosti disease" is sometimes reserved for patients with GCS that is documented to be related to hepatitis B virus (HBV) infection .