Gianotti-Crosti Syndrome: A Benign Dermatosis.

Gianotti-Crosti syndrome (GCS) is a benign acral dermatitis commonly seen in children younger than five years of age with no gender predilection. Clinical features are often vague, including but not limited to fever, lymphadenopathy, and erythematous papular rash that commonly spares the trunk, palms, and soles of the feet. It is presumably underdiagnosed as most children presenting with a widespread papular rash are diagnosed with non-specific viral exanthem. This benign condition has been linked to multiple viruses, and treatment is mainly supportive. We present a previously healthy 18-month-old girl who presented to the emergency room with a progressive skin rash and low-grade fever 10 days after receiving routine immunizations. GCS was diagnosed, and she received supportive care with spontaneous resolution of symptoms in four weeks.

A rare case of chronic Gianotti-Crosti syndrome: A case report.

Gianotti-Crosti syndrome, also known as papular acrodermatitis of childhood, is a common, self-limiting dermatosis often seen in children with triggers including viral and bacterial infections along with immunizations. Lesions are generally described as asymptomatic, skin colored to erythematous papules and papulovesicles that often spontaneously resolve within weeks. Here, we will discuss Gianotti-Crosti syndrome and present a rare case of chronic Gianotti-Crosti syndrome in an otherwise healthy 3-year-old male persisting for over 20 months. From this report, we aim to better educate the dermatologic community on the extremes of the Gianotti-Crosti syndrome disease course to improve diagnosis and treatment of symptomatic patients.

An update on Epstein-Barr virus-and human T-lymphotropic virus type-1-induced cutaneous manifestations. CME Part II.

The Epstein-Barr virus (EBV) is a DNA virus that infects 90% of the human population, is responsible for certain cutaneous lymphomas (extranodal NK/T-cell lymhoma, hydroa vacciniforme lymphoproliferative disorder, lymphomatoid granulomatosis, others), and can be associated with a variety of cutaneous manifestations (eg, infectious mononucleosis, severe mosquito bite allergy, chronic active EBV disease, Gianotti-Crosti syndrome). EBV-related skin disorders are frequent in certain populations (South and Cental America, Africa, Asia, and Oceania) and can be diagnostically challenging. The human T-lymphotropic virus type-1 is a retrovirus, which is known to be associated with adult T-cell leukemia/lymphoma, neurologic disorders, but also cutaneous non-neoplastic manifestations (infective dermatitis, infections, and infestations). We performed an updated revision of the clinical dermatologic and histopathologic findings associated with the cutaneous non-neoplastic and preneoplastic disorders occurring in association with the EBV and human T-lymphotropic virus type-1.

Pattern of Papulosquamous Disorders in Children: A Clinico-Epidemiological Study.

Introduction Skin disorders are a major health problem in the pediatric age group and are associated with significant morbidity. Papulosquamous disorders, forming a major part of the skin diseases in children, present in a variety of clinical pattern. This study is conducted in order to study the hospital-based prevalence of papulosquamous disorders in the pediatric age group (2-14 years) and to determine the morphology and clinical patterns with respect to their age and sex distribution. Methodology An analytical cross-sectional study was conducted from December 1, 2019, to May 30, 2021, in the outpatient department of the Department of Dermatology, Venereology, and Leprology, JK Hospital and LN Medical College, Bhopal, India. Ninety-five consecutive patients belonging to the age group of 2-14 years, attending the Dermatology OPD and also referred cases from the Pediatrics Department were enrolled in the study. A detailed history of illness, regarding age, duration, onset, symptoms, recurrence, family history of the disease, pre-existing medical conditions, and drug intake history was taken. Information regarding the history of fever, sore throat, and vaccination was noted. Clinical and dermatological examination including hair, nail, and mucosal examination was done for all the cases. Necessary investigations were ordered for relevant cases and the data was recorded in a form specially designed for the study. Results In the present study, papulosquamous disorders constituted 2.9% of all pediatric (2-14 years) dermatosis. Of the various papulosquamous disorders found, psoriasis was the most common disease that was found (in 31.6%) followed by Gianotti-Crosti syndrome (18.9%), and lichen planus (18.9%). Males outnumbered females with a ratio of 1.48:1. The incidence of papulosquamous disorders was highest in 11-14 years of age in the present study. Conclusion Papulosquamous disorders account for a large number of the overall dermatoses, belonging to both the adult and pediatric populations. Due to significant changes in clinical presentation, geographical and environmental influences, treatment, and prognosis; the papulosquamous group of disorders in children require a varying approach than adult dermatoses. More studies are required in this field to appropriately diagnose and manage pediatric papulosquamous disorders in order to reduce the disease burden and as a key to better patient care.

Gianotti-Crosti syndrome-like reaction to molluscum contagiosum-Clinical characteristics and response to treatment.

BACKGROUND AND OBJECTIVES: Molluscum contagiosum (MC) is a common viral infection. Hypersensitivity reactions reminiscent of Gianotti-Crosti syndrome, termed Gianotti-Crosti syndrome-like reaction (GCLR), have been reported in a subset of patients. We report a series of patients with GCLR, better delineating its clinical presentation and course. PATIENTS AND METHODS: Retrospective chart review of all children presenting with GCLR at our Pediatric Skin Center between 2015 and 2020. RESULTS: 26 children (14 boys) with a median age of 6.5 (3-11.3) years were included. GCLR involved the extensor surfaces of the extremities in all patients. More widespread eruptions also affected the trunk and face in 7 (27 %) and 6 (23 %) children respectively. Involvement of the skin overlying the Achilles tendons was a new finding in 4 (15 %) children. Itch was the predominant symptom in 20 (77 %) patients. The rash responded to topical and/or systemic corticosteroids and resolved within four weeks. GCLR was followed by clearance of MC in all patients within 9 (4-24) weeks. CONCLUSIONS: GCLR is a characteristic acute, wide-spread, pruritic papular eruption, which often leads to emergency consultations and anxiety in affected patients. GCLR responds well to corticosteroid treatment, has a benign course, and heralds the healing of MC.

Extraoral exanthem revealing Gianotti-Crosti syndrome in a young child: A case report.

We reported a case of a 14-month-old girl with erythematous and papulovesicular pink to red lesions on the face, the upper and the lower limbs. The history and the morphological features confirmed the diagnosis of Gianotti-Crosti syndrome.

A case of recurrent vaccine-triggered Gianotti-Crosti syndrome.

Gianotti-Crosti syndrome (GCS) is a self-limited benign dermatosis, clinically characterized by a monomorphic papular or papulovesicular eruption symmetrically distributed on the limbs and face of children. Various viral and vaccine triggers have been associated with GCS. Recurrences are uncommon but have been reported. We report a case of recurrent vaccine-triggered GCS.

The Serum Immunoglobulin E Level: Is There a Relationship With the Clinical Course of the Gianotti-Crosti Syndrome?

Background: Gianotti Crosti syndrome (GCS) is a self-healing condition with a spontaneous resolution in 2-6 weeks but, even if rarely, recurrent episodes have been reported. Objective: The aim of this observational study is to investigate serum Immunoglobulin E (IgE) level in children with GCS, evaluating if there is a relationship between IgE level and clinical course of the disease. Methods: Children with GCS diagnosed at a tertiary care children's university hospital between June 2018 and November 2019 were prospectively enrolled. Demographic, clinical and hematochemical data of children investigated were collected. In particular, IgE level were investigated at symptoms onset and, if available, at the following blood tests. Patients were divided in 2 groups on the bases of the clinical course: children with a chronic relapsing course and children who did not present any relapse. Results: Among 29 patients enrolled in this study, 14 (48.3%) children had a chronic relapsing course and 15 (51.7%) did not present any relapse. A statistically significant difference was present considering the length of the disease: 210 days (IQR: 161.25-255) for patients with a chronic relapsing course compared to 40 days (IQR: 30-75) for the other group (p < 0.0001). About the median IgE level in the 2 groups, a value about 10 time higher was found in children with chronic course compared to the other group (1,144 vs. 116 U/mL) with a statistically significant difference (p < 0.0001). Conclusion: Despite the study limitations, a significant correlation between higher IgE levels and chronic-relapsing course of the GCS can be assumed.

Síndrome de GianottiCrosti:diagnóstico a considerar en pacientes pediátricos con exantemas acrales / Gianotti Crosti syndrome: a diagnosis to consider in pediatric patients with acral exanthema

Resumen Los exantemas virales en la infancia,son motivo deconsulta frecuente, en los Servicios de Dermatología, Pediatría, y Urgencias. Usualmente, son autolimitados y pueden ser difíciles de diagnosticar. Es importante reconocerlos y diferenciarlos de otras enfermedades severas que requieran un tratamiento inmediato. El síndrome de Gianotti-Crosti, también conocido como acrodermatitispapulosa de la infancia, es un exantema poco frecuente, secundario a la respuesta inmune del huésped frente a infecciones, especialmente virales o luego de inmunizaciones. La primera asociación descrita fue con la infección por el virus de hepatitis B, sin embargo, con la introducción de la vacuna contra este virus, aumentó la incidencia de otros virus relacionados con este síndrome. Presentamos el caso de un paciente de 4 años de edad con diagnóstico clínico de síndrome de Gianotti-Crosti.

Abstract Viralexanthemsin childhood are a frequent consultation both outpatient and in emergency services. They are usually self-limited and can be difficult to diagnose. It's important to recognize and differentiate them from other severe diseases that require immediate treatment. GianottiCrosti syndrome, also known as papularacrodermatitis of childhood, is an infrequent exanthema secondary to the host's immune response to infections, especially viral, or vaccines. The first association described was with hepatitis B virus infection, however, with the introduction of the vaccine against this virus,the incidence of other viruses related to this syndrome has increased. We present the case of a 4-year-old patient with a clinical diagnosis of GianottiCrosti syndrome.

[Acute skin infections and their imitators in children : A photo quiz]. / Akute Hautinfektionen und deren Imitatoren im Kindesalter : Ein Bilderquiz.

BACKGROUND: Skin infections account for 40% of emergency visits in pediatric dermatology. It is important to promptly recognize skin infections with potential complications and initiate treatment. However some characteristic skin findings may imitate skin infections and are often misdiagnosed. OBJECTIVES: To illustrate frequent pediatric skin infections and pitfalls in view of imitators and differential diagnoses. MATERIALS AND METHODS: A photo quiz is presented with the discussion of a selection of acute pediatric skin infections in comparison to their infectious or noninfectious differential diagnoses. RESULTS: The following infectious skin conditions and imitators are described and clinical clues for differentiation highlighted: eczema herpeticum and bacterial superinfection of atopic dermatitis; exanthematous hand, foot and mouth disease and varicella infection; erythema chronicum multilocularis and anular urticaria; Gianotti-Crosti syndrome and Gianotti-Crosti-like reaction; bacterial folliculitis of the scalp and kerion celsi and eosinophilic pustular folliculitis of the scalp; cutaneous Leishmaniasis and idiopathic facial aseptic granuloma; allergic and bacterial lymphangitis; bullous impetigo contagiosa and nonaccidental scalding. CONCLUSIONS: Careful anamnesis and skin examination with attention to the here illustrated differential diagnoses are essential to avoid pitfalls in the evaluation of acute pediatric skin infections.

[Paraviral exanthems]. / Paravirale Exantheme.

Paraviral exanthems are distinct skin diseases due to infections with different viruses. Although no virus has been identified so far in some exanthems, the main age of manifestation, the clinical course of the exanthem, and the extracutaneous symptoms are suggestive for a viral genesis. While many viral infections are a direct result of the infection, paraviral exanthems reflect the response of the immune system to the infectious pathogens. Viruses cannot be identified in the skin. Typical paraviral exanthems include Gianotti-Crosti syndrome, pityriasis rosea, pityriasis lichenoides, papular-purpuric gloves and sock syndrome, and asymmetrical periflexural exanthema. Unilateral mediothoracic exanthem, eruptive pseudoangiomatosis are rare and eruptive hypomelanosis has been described recently.

Paraviral exanthems.

INTRODUCTION: Paraviral exanthems are skin diseases suspected to be caused by viruses, with a single virus-exanthem relationship not universally accepted. Although most paraviral exanthems are self-remitting, accurate diagnoses are important as some patients might develop complications. Some of the differential diagnoses might cause serious complications, and some paraviral exanthems might lead to complications for at-risk groups such as pregnant women. Moreover, some paraviral exanthems might be symptomatic such as the development of severe pruritus, with relief of such being crucial in the plan of management. Patients and carers of patients should also be counselled regarding the aetiologies, clinical features, and prognoses of the exanthems concerned. AREAS COVERED: We covered the clinical manifestations and managements of pityriasis rosea, pityriasis lichenoides, and Gianotti-Crosti syndrome. Expert Commentary: Most patients with pityriasis rosea do not need any active intervention. Symptomatic relief of the pruritus would be adequate. For patients with pityriasis rosea that are serious, extensive, or causing severe impacts of their quality of life, oral acyclovir could be considered. For pityriasis lichenoides, managements would be depending on the type of the exanthem such as the acute form (pityriasis lichenoides et varioliformis acuta, also known as Mucha Habermann disease) the chronic form (pityriasis lichenoides chronic Juliusberg's disease), and the febrile ulceronecrotic Mucha-Habermann disease, which is a complication of the acute form. The management of Gianotti-Crosti syndrome is mainly symptomatic. The need for long-term follow-up for chronic complications of the underlying viral infections is still controversial.

Gianotti-Crosti syndrome as presenting sign of cytomegalovirus infection: A case report and a critical appraisal of its possible cytomegalovirus etiology.

Gianotti-Crosti syndrome (GCS) is a self-limiting exanthem of acute onset with a characteristic acral distribution, usually occurring in children. It is characterized by symmetric pink to red-brown papular or papulovesicular lesions that are a few millimetres in diameter, distributed on the face, buttocks and limbs. It may be accompanied by low-grade fever, hepato-splenomegaly and lymphadenopathy. GCS is considered a unique cutaneous response to viral infection, mostly associated with hepatitis B virus and Epstein-Barr virus (EBV), but other viruses, bacterial infections and recent immunizations may be inciting factors. We report a case of a 3-year-old girl presenting generalized, pruritic, papulovesicular eruption on the face and extremities for one month. In our case, GCS was related to cytomegalovirus (CMV) primary infection and may be considered the presenting sign of the infection.

Gianotti-Crosti Syndrome following immunization in an 18 months old child.

Gianotti-Crosti syndrome (GCS) is an uncommon dermatological condition characterized by distinct, self-limiting, symmetrical, erythematous, papulovesicular eruptions distributed mainly on the extremities, buttocks and face in young children. Although GCS is commonly attributed to viral infections, vaccinations too can rarely precipitate this condition. We report a rare case of GCS following diptheria, pertussis, and tetanus (DPT) and oral polio immunisation in an 18-month-old child along with a review of similar vaccine-induced GCS cases reported in the literature.