Gianotti Crosti syndrome

Gianotti 1955, Crosti und Gianotti 1956.

Acrodermatitis papulosa eruptiva infantilis, Acrodermatitis papulosa eruptiva infantilis, Akrodermatitis papulose eruptive infantilis, infantile papulöse Akrodermatitis, infantiles akrolokalisiertes papulovesikulöses Syndrom, GCS.

Minor childhood contagious disease.

• Boys are more frequently affected.
• Mostly occurring at the age of 2-6 years.
• Seasonal accumulation in spring and autumn.

• Incubation period: 1-6 weeks.

• A viral infection (HBV, EBV, coxsackie virus, cytomegaloviruses, adenoviruses, enteroviruses, HHV-6, HHV-7, HIV, RSV, parainfluenza virus, parvovirus B19) or a vaccination (sometimes up to 6 weeks ago) can be the trigger. In special cases, irritation of Mollusca contagiosa can lead to a generalized Gianotti-Crosti syndrome.

In the past, hepatitis was thought to be the cause, which was not confirmed.

• After 3-4 days, erythematous, succulent, confluent lichenoid papules.

• The prodromi are uncharacteristic. General symptoms: Elevated (subfebrile) temperature, lymphadenopathy, dyspepsia, rhinopharyngitis, bronchitis, tonsillitis, occasional hepatomegaly, reactive polylymphadenitis. fatigue, headaches.

• Laboratory: Blood count (leukocytosis, lymphocytosis and monocytosis), BSG, CRP, HBs-AG, HBe-AG, liver values, bilirubin, protein electrophoresis (reproduction of β-, β- and later α-globulins).

Acra (cheeks, extremity sides and buttocks).

• Spongiosis, hyper- and parakeratosis, secondary acanthosis and exocytosis are visible in the epidermis.

• The papillary stratum and the reticular stratum show subacute vasculitis with perivascular edema and lymphohistiocytic infiltration.

Healing after 2-8 weeks.

1. Baldari U, Monti A, Righini MG. An Epidemic of Infantile Papular Acrodermatitis (Gianotti-Crosti Syndrome) due to Epstein-Barr Virus. Dermatology 1994;188:203-4.
2. Brandt O, Abeck D, Gianotti R, Burgdorf W. Gianotti-Crosti syndrome. Journal of the American Academy of Dermatology 2006;54:136-45.
3. Caputo R, Gelmetti C, Ermacora E, Gianni E, Silvestri A. Gianotti-Crosti syndrome: A retrospective analysis of 308 cases. Journal of the American Academy of Dermatology 1992;26:207-10.
4. Chuh A, Zawar V, Sciallis GF, Kempf W, Lee A. Pityriasis Rosea, Gianotti-Crosti Syndrome, Asymmetric Periflexural Exanthem, Papular-Purpuric Gloves and Socks Syndrome, Eruptive Pseudoangiomatosis, and Eruptive Hypomelanosis: Do Their Epidemiological Data Substantiate Infectious Etiologies? Infect Dis Rep 2016;8:6418.
5. Chuh AAT. Truncal lesions do not exclude a diagnosis of Gianotti-Crosti syndrome. Australas J Dermatol 2003;44:215-6.
6. Haug S, Schnopp C, Ring J, Fölster-Holst R, Abeck D. Gianotti-Crosti-Syndrom nach Impfung. Hautarzt 2002;53:683-5.
7. Magyarlaki M, Drobnitsch I, Schneider I. Papular Acrodermatitis of Childhood (Gianotti-Crosti Disease). Pediatric Dermatology 1991;8:224-7.
8. Ricci G, Patrizi A, Neri I, Specchia F, Tosti G, Masi M. Gianotti-Crosti Syndrome and Allergic Background. Acta Dermato-Venereologica 2003;83:202-5.
9. Smith KJ, Skelton H. Histopathologic features seen in Gianotti-Crosti syndrome secondary to Epstein-Barr virus. Journal of the American Academy of Dermatology 2000;43:1076-9.
10. Stefanato CM, Goldberg LJ, Andersen WK, Bhawan J. Gianotti-Crosti Syndrome Presenting as Lichenoid Dermatitis. The American Journal of Dermatopathology 2000;22:162-5.
11. Terasaki K, Koura S, Tachikura T, Kanzaki T. Gianotti-Crosti Syndrome Associated with Endogenous Reactivation of Epstein-Barr Virus. Dermatology 2003;207:68-71.
12. Velangi, Tidman. Gianotti-Crosti syndrome after measles, mumps and rubella vaccination. British Journal of Dermatology 1998;139:1122-3.
13. Yoshida M, Tsuda N, Morihata T, Sugino H, Iizuka T. Five patients with localized facial eruptions associated with Gianotti-Crosti syndrome caused by primary Epstein-Barr virus infection. The Journal of Pediatrics 2004;145:843-4.