Gianotti-Crosti Syndrome
Gianotti-Crosti Syndrome (GCS)
Introduction
Gianotti-Crosti syndrome, also known as papular acrodermatitis of childhood, is a distinctive self-limiting acral papular eruption associated with various viral infections and immunizations.
Key Points
- Most commonly affects children aged 1-6 years
- Associated with Epstein-Barr virus (EBV) and hepatitis B virus (HBV)
- Characterized by symmetric acral distribution
- Self-limiting condition with excellent prognosis
Clinical Features
Cutaneous Manifestations
- Monomorphous, pink-brown papules or papulovesicles
- Size: 1-10 mm in diameter
- Distribution: Symmetric involvement of:
- Cheeks
- Extensor surfaces of extremities
- Buttocks
- Spares trunk and mucous membranes
Associated Symptoms
- Mild pruritus
- Lymphadenopathy (50-75% of cases)
- Hepatomegaly (rare)
- Low-grade fever
- Upper respiratory symptoms
Diagnosis
Diagnostic Criteria
- Clinical appearance of characteristic eruption
- Age typically between 1-6 years
- Symmetric acral distribution
- Duration of 10-60 days
Associated Conditions
- Viral Infections:
- Epstein-Barr virus (most common)
- Hepatitis B virus
- Cytomegalovirus
- Coxsackievirus
- Respiratory syncytial virus
- Immunizations:
- MMR vaccine
- DPT vaccine
- Oral polio vaccine
Management
Treatment Approach
- Supportive care (primary treatment)
- Symptomatic relief:
- Topical emollients
- Oral antihistamines for pruritus
- Topical steroids (if severe pruritus)
- Parent education about self-limiting nature
- Treatment of underlying viral infection if identified
Prognosis
- Excellent prognosis
- Self-limiting condition
- Resolution within:
- Average: 3-8 weeks
- Range: 10-60 days
- No scarring
- Rare recurrences
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