Gianotti-Crosti syndrome (papular acrodermatitis)

INTRODUCTION

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-F). 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].

TERMINOLOGY

In the original descriptions, Gianotti-Crosti syndrome (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

                            

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Literature review current through: Aug 2014. | This topic last updated: May 22, 2014.
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References
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  1. GIANOTTI F. [Report on a special case of toxic infection characterized by a desquamative erythemato-infiltrative eruption with lenticular foci and a selective localization at the extremities]. Soc Ital Dermatol Sifilogr Sezioni Interprov Soc Ital Dermatol Sifilogr 1955; 96:678.
  2. CROSTI A, GIANOTTI F. [Eruptive dermatosis of probable viral origin situated on the acra]. Dermatologica 1957; 115:671.
  3. Gianotti F. [Viral anicteric hepatitis in infantile papular acrodermatitis]. Epatologia 1966; 12:171.
  4. Gianotti F. [Infantile papular acrodermatitis. Acrodermatitis papulosa and the infantile papulovesicular acrolocalized syndrome]. Hautarzt 1976; 27:467.
  5. Gianotti F. Papular acrodermatitis of childhood and other papulo-vesicular acro-located syndromes. Br J Dermatol 1979; 100:49.
  6. Claudy AL, Ortonne JP, Trepo C, Bugnon B. [Adult papular acrodermatitis (Gianotti's disease). Report of 3 cases]. Ann Dermatol Venereol 1977; 104:190.
  7. Niitsuma H, Ishii M, Ojima T, et al. [A case of acute hepatitis infected with hepatitis B virus during pregnancy and complicated by Gianotti-Crosti syndrome]. Nihon Shokakibyo Gakkai Zasshi 1999; 96:423.
  8. Gibbs S, Burrows N. Gianotti-Crosti syndrome in two unrelated adults. Clin Exp Dermatol 2000; 25:594.
  9. Caputo R, Gelmetti C, Ermacora E, et al. Gianotti-Crosti syndrome: a retrospective analysis of 308 cases. J Am Acad Dermatol 1992; 26:207.
  10. Brandt O, Abeck D, Gianotti R, Burgdorf W. Gianotti-Crosti syndrome. J Am Acad Dermatol 2006; 54:136.
  11. Jindal T, Arora VK. Gianotti-crosti syndrome. Indian Pediatr 2000; 37:683.
  12. Taïeb A, Plantin P, Du Pasquier P, et al. Gianotti-Crosti syndrome: a study of 26 cases. Br J Dermatol 1986; 115:49.
  13. Brown J, Rentiers P. The Gianotti-Crosti syndrome: a distrinctive exanthem. Can Med Assoc J 1969; 100:773.
  14. Toda G, Ishimaru Y, Mayumi M, Oda T. Infantile papular acrodermatitis (Gianotti's disease) and intrafamilial occurence of acute hepatitis B with jaundice: age dependency of clinical manifestations of hepatitis B virus infection. J Infect Dis 1978; 138:211.
  15. Ishimaru Y, Ishimaru H, Toda G, et al. An epidemic of infantile papular acrodermatitis (Gianotti's disease) in Japan associated with hepatitis-B surface antigen subtype ayw. Lancet 1976; 1:707.
  16. Kanzaki S, Kanda S, Terada K, et al. Detection of hepatitis B surface antigen subtype adr in an epidemic of papular acrodermatitis of childhood (Gianotti's disease). Acta Med Okayama 1981; 35:407.
  17. Baldari U, Monti A, Righini MG. An epidemic of infantile papular acrodermatitis (Gianotti-Crosti syndrome) due to Epstein-Barr virus. Dermatology 1994; 188:203.
  18. 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 2004; 145:843.
  19. Demattei C, Zawar B, Lee A, et al. Spatial-temporal case clustering in children with Gianotti-Crosti syndrome. Systematic analysis led to the identification of a mini-epidemic. Eur J Pediat Dermatol 2006; 16:159.
  20. Colombo M, Rumi MG, Sagnelli E, et al. Acute hepatitis B in children with papular acrodermatitis. Pediatr Pathol 1986; 6:249.
  21. Lee S, Kim KY, Hahn CS, et al. Gianotti-Crosti syndrome associated with hepatitis B surface antigen (subtype adr). J Am Acad Dermatol 1985; 12:629.
  22. Claudy AL, Ortonne JP, Trepo C, Bugnon B. Papular acrodermatitis associated with hepatitis B virus infection. Arch Dermatol 1979; 115:931.
  23. Rubenstein D, Esterly NB, Fretzin D. The Gianotti-Crosti syndrome. Pediatrics 1978; 61:433.
  24. Smith KJ, Skelton H. Histopathologic features seen in Gianotti-Crosti syndrome secondary to Epstein-Barr virus. J Am Acad Dermatol 2000; 43:1076.
  25. Maeda S, Tsuda H, Haruki S, Mitsuto I. Atypical Epstein-Barr virus infection associated with Gianotti-Crosti syndrome and Bell's palsy. Pediatr Int 1999; 41:315.
  26. Drago F, Crovato F, Rebora A. Gianotti-Crosti syndrome as a presenting sign of EBV-induced acute infectious mononucleosis. Clin Exp Dermatol 1997; 22:301.
  27. Hofmann B, Schuppe HC, Adams O, et al. Gianotti-Crosti syndrome associated with Epstein-Barr virus infection. Pediatr Dermatol 1997; 14:273.
  28. Konno M. [An association between hepatitis-B antigen-negative infantile papular acrodermatitis and Epstein-Barr virus infection]. Hokkaido Igaku Zasshi 1989; 64:125.
  29. James WD, Odom RB, Hatch MH. Gianotti-Crosti-like eruption associated with coxsackievirus A-16 infection. J Am Acad Dermatol 1982; 6:862.
  30. Draelos ZK, Hansen RC, James WD. Gianotti-Crosti syndrome associated with infections other than hepatitis B. JAMA 1986; 256:2386.
  31. Tzeng GH, Hsu CY, Chen HC. Gianotti-Crosti syndrome associated with cytomegalovirus infection: report of one case. Zhonghua Min Guo Xiao Er Ke Yi Xue Hui Za Zhi 1995; 36:139.
  32. Berant M, Naveh Y, Weissman I. Papular acrodermatitis with cytomegalovirus hepatitis. Arch Dis Child 1983; 58:1024.
  33. Haki M, Tsuchida M, Kotsuji M, et al. Gianotti-Crosti syndrome associated with cytomegalovirus antigenemia after bone marrow transplantation. Bone Marrow Transplant 1997; 20:691.
  34. Carrascosa JM, Just M, Ribera M, Ferrándiz C. Papular acrodermatitis of childhood related to poxvirus and parvovirus B19 infection. Cutis 1998; 61:265.
  35. Léger F, Callens A, Machet MC. [Parvovirus B19 primo-infection and cold agglutinins]. Ann Dermatol Venereol 1997; 124:257.
  36. Boeck K, Mempel M, Schmidt T, Abeck D. Gianotti-Crosti syndrome: clinical, serologic, and therapeutic data from nine children. Cutis 1998; 62:271.
  37. Hergueta Lendínez R, Pozo García L, Alejo García A, et al. [Gianotti-Crosti syndrome due to a mixed infection produced by the mumps virus and the parainfluenza virus type 2]. An Esp Pediatr 1996; 44:65.
  38. Sagi EF, Linder N, Shouval D. Papular acrodermatitis of childhood associated with hepatitis A virus infection. Pediatr Dermatol 1985; 3:31.
  39. Pouillaude JM, Moulin G, Morlat C, François R. [Gianotti-Crosti's infantile papular acrodermatitis. Nosological relationship with viral hepatitis. A fatal outcome]. Pediatrie 1975; 30:351.
  40. Di Lernia V. Gianotti-Crosti syndrome related to rotavirus infection. Pediatr Dermatol 1998; 15:485.
  41. Di Lernia V, Ricci C. Skin manifestations with Rotavirus infections. Int J Dermatol 2006; 45:759.
  42. de la Torre C. Gianotti-Crosti syndrome following milkers' nodules. Cutis 2004; 74:316.
  43. Blauvelt A, Turner ML. Gianotti-Crosti syndrome and human immunodeficiency virus infection. Arch Dermatol 1994; 130:481.
  44. Yasumoto S, Tsujita J, Imayama S, Hori Y. Case report: Gianotti-Crosti syndrome associated with human herpesvirus-6 infection. J Dermatol 1996; 23:499.
  45. Chuh AA, Chan HH, Chiu SS, et al. A prospective case control study of the association of Gianotti-Crosti syndrome with human herpesvirus 6 and human herpesvirus 7 infections. Pediatr Dermatol 2002; 19:492.
  46. Angoulvant N, Grézard P, Wolf F, et al. [Acute Mycoplasma pneumoniae infection: new cause of Gianotti Crosti syndrome]. Presse Med 2000; 29:1287.
  47. Manoharan S, Muir J, Williamson R. Gianotti-Crosti syndrome in an adult following recent Mycoplasma pneumoniae infection. Australas J Dermatol 2005; 46:106.
  48. Silveira Cancela M, Valdés Tascón F, Pita Carretero J, et al. [Neonatal papular acrodermatitis (Gianotti-Crosti) and Bartonella henselae infection]. An Esp Pediatr 2000; 52:299.
  49. Baldari U, Cattonar P, Nobile C, et al. Infantile acrodermatitis of Gianotti-Crosti and Lyme borreliosis. Acta Derm Venereol 1996; 76:242.
  50. Cambiaghi S, Scarabelli G, Pistritto G, Gelmetti C. Gianotti-Crosti syndrome in an adult after influenza virus vaccination. Dermatology 1995; 191:340.
  51. Velangi SS, Tidman MJ. Gianotti-Crosti syndrome after measles, mumps and rubella vaccination. Br J Dermatol 1998; 139:1122.
  52. Andiran N, Sentürk GB, Bükülmez G. Combined vaccination by measles and hepatitis B vaccines: a new cause of Gianotti-Crosti syndrome. Dermatology 2002; 204:75.
  53. Karakaş M, Durdu M, Tuncer I, Cevlik F. Gianotti-Crosti syndrome in a child following hepatitis B virus vaccination. J Dermatol 2007; 34:117.
  54. Erkek E, Senturk GB, Ozkaya O, Bükülmez G. Gianotti-Crosti syndrome preceded by oral polio vaccine and followed by varicella infection. Pediatr Dermatol 2001; 18:516.
  55. Kolivras A, André J. Gianotti-Crosti syndrome following hepatitis A vaccination. Pediatr Dermatol 2008; 25:650.
  56. Kang NG, Oh CW. Gianotti-Crosti syndrome following Japanese encephalitis vaccination. J Korean Med Sci 2003; 18:459.
  57. Milbradt R, Nasemann T. [Entity of the Gianotti-Crosti's syndrome and its relation to hepatitis B infection]. Hautarzt 1975; 26:471.
  58. Magyarlaki M, Drobnitsch I, Schneider I. Papular acrodermatitis of childhood (Gianotti-Crosti disease). Pediatr Dermatol 1991; 8:224.
  59. Ricci G, Patrizi A, Neri I, et al. Gianotti-Crosti syndrome and allergic background. Acta Derm Venereol 2003; 83:202.
  60. Paller AS, Mancini AJ. The exanthematous diseases of childhood. In: Hurwitz Clinical Pediatric Dermatology: A Textbook of Skin Disorders of Childhood and Adolescence, 3rd ed, WB Saunders, Philadelphia 2006. p.423.
  61. Chuh AA. Truncal lesions do not exclude a diagnosis of Gianotti-Crosti syndrome. Australas J Dermatol 2003; 44:215.
  62. Baleviciené G, Maciuleviciené R, Schwartz RA. Papular acrodermatitis of childhood: the Gianotti-Crosti syndrome. Cutis 2001; 67:291.
  63. Tilly JJ, Drolet BA, Esterly NB. Lichenoid eruptions in children. J Am Acad Dermatol 2004; 51:606.
  64. Spear KL, Winkelmann RK. Gianotti-Crosti syndrome. A review of ten cases not associated with hepatitis B. Arch Dermatol 1984; 120:891.
  65. Chuh A, Lee A, Zawar V. The diagnostic criteria of Gianotti-Crosti syndrome: are they applicable to children in India? Pediatr Dermatol 2004; 21:542.
  66. Colombo M, Gerber MA, Vernace SJ, et al. Immune response to hepatitis B virus in children with papular acrodermatitis. Gastroenterology 1977; 73:1103.
  67. Patrizi A, Di Lernia V, Neri I, Ricci G. An unusual case of recurrent Gianotti-Crosti syndrome. Pediatr Dermatol 1994; 11:283.
  68. Gabrielsen TO, Rajka G, Rustenberg B. [Acrodermatitis papulosa eruptiva infantum as a prodrome in hepatitis B infection]. Z Hautkr 1985; 60:1793.
  69. American Academy of Pediatrics. Hepatitis B. In: Red Book: 2009 Report of the Committee on Infectious Diseases, 28th ed, Pickering LK (Ed), American Academy of Pediatrics, Elk Grove Village, IL 2009. p.337.
  70. Chuh A, Zawar V, Law M, Sciallis G. Gianotti-Crosti syndrome, pityriasis rosea, asymmetrical periflexural exanthem, unilateral mediothoracic exanthem, eruptive pseudoangiomatosis, and papular-purpuric gloves and socks syndrome: a brief review and arguments for diagnostic criteria. Infect Dis Rep 2012; 4:e12.
  71. Zawar V, Chuh A. Gianotti-crosti syndrome in India is not associated with hepatitis B infection. Dermatology 2004; 208:87.
  72. Nelson JS, Stone MS. Update on selected viral exanthems. Curr Opin Pediatr 2000; 12:359.
  73. Stone MS, Murph JR. Papular-purpuric gloves and socks syndrome: a characteristic viral exanthem. Pediatrics 1993; 92:864.
  74. Harms M, Feldmann R, Saurat JH. Papular-purpuric "gloves and socks" syndrome. J Am Acad Dermatol 1990; 23:850.
  75. Hsieh MY, Huang PH. The juvenile variant of papular-purpuric gloves and socks syndrome and its association with viral infections. Br J Dermatol 2004; 151:201.
  76. Grilli R, Izquierdo MJ, Fariña MC, et al. Papular-purpuric "gloves and socks" syndrome: polymerase chain reaction demonstration of parvovirus B19 DNA in cutaneous lesions and sera. J Am Acad Dermatol 1999; 41:793.