Gianotti-Crosti Syndrome (GCS) is a rare viral exanthem that is often associated with Epstein-Barr virus infections (EBV), although many other viral infections have been reported. Also known as Papulovesicular Acrodermatitis of Childhood, Infantile Papular Acrodermatitis, and Acrodermatitis Papulosa Infantum, the eruption usually afflicts children between the ages of 6 months to 14 years. The lesions develop over a few days but last longer than most other viral exanthems…10 days to many weeks.
Lesion numbers may vary from a few to a generalzied eruption coalescing into plaques covering the face, trunk, and extremities, as shown in these photographs. Koebner phenomenon, lesions arising within ares of trauma, such as a scratch as shown on the photograph of the arm directly above, may occur. Pruritus is variable and the mucous membranes are mostly spared. Lymphadenopathy may develop, most commonly involving the axillary and/or inguinal nodes and last for 2-3 months.
The clinical features of GCS are independent of the cause and are fairly characteristic. These are reviewed nicely in Andrews’ Textbook of Dermatology:
- Monomorphous, flat-topped, pink-brown papules or papulovesicles of 1-10 mm in diameter
- Any three or all four sites involved-face, buttocks, forearms and extensor legs
- Duration of at least 10 days
Negative clinical features include:
- Estensive truncal lesions
- Scaly lesions
ETIOLOGY: EBV is the most common cause, but other infectious agents have been reported to include adenovirus, cytomegalovirus (CMV), enteroviruses (coxsackie A16, B4 and B5), vaccinia, rotavirus, hepatitis A and C, respiratory syncytial virus, parainfluenza virus, parvovirus B19, rubella, HHV-6, strptococus and Mycobacterium avium. Immmunizations against poliovirus, diphtheria, pertussis, Japanese encephalitis, influenza and hepatitis B along with measles have also been reported to induce GCS.