Gianotti-Crosti Syndrome - Causes, Symptoms, Diagnosis, and Treatment

Introduction

Gianotti-Crosti syndrome is a rare skin condition characterized by skin blisters in the legs, upper extremities, and buttocks. It is observed that the Gianotti-Crosti syndrome most commonly affects children between the age group of five months to nine years. Gianotti-Crosti syndrome is usually present in children associated with upper respiratory infections. The suggested cause of Gianotti-Crosti syndrome is a viral infection such as hepatitis B infection. However, Gianotti-Crosti syndrome is a self-limiting skin condition. The treatment is primarily done to manage the symptoms. Gianotti-Crosti syndrome has no gender or genetic preferences.

What Is Gianotti-Crosti Syndrome?

Gianotti-Crosti syndrome is a rare skin condition affecting children between five months to nine years old. Gianotti-Crosti syndrome is also known as acrodermatitis, characterized by skin blisters in the upper extremities, legs, and face. Gianotti-Crosti syndrome is preceded by a viral infection and presents in association with upper respiratory tract infection. It is also observed that the predisposing factors of Gianotti-Crosti syndrome include hepatitis B infection. The symptoms of Gianotti-Crosti syndrome usually last for three to weeks and are resolved independently. Various names known as Gianotti-Crosti syndrome and the other terms of Gianotti-Crosti syndrome are mentioned below:

• Papular Acrodermatitis of Childhood or PAC.

• Acrodermatitis, papular infantile.

• Acrodermatitis, infantile lichenoid.

• Crosti-Gianotti Syndrome or CGS.

• Gianotti-Crosti syndrome or GCS.

• Papular Acrodermatitis Syndrome or PAS.

What Are the Causes of Gianotti-Crosti Syndrome?

Gianotti-Crosti syndrome, or papular acrodermatitis of childhood, is a benign skin condition characterized by acute symptoms. The papular acrodermatitis of childhood, or Gianotti-Crosti syndrome, was first described in the 1950s. Gianotti-Crosti syndrome was a skin manifestation of hepatitis B viral infection. Later, Gianotti-Crosti syndrome was suggested with various etiologies. Some other etiologies of Gianotti-Crosti syndrome are mentioned below:

• Hepatitis B viral infection.

• Anicteric hepatitis.

• Epstein Barr virus.

• Cytomegalovirus.

• Coxsackievirus.

• Adenovirus.

• Hepatitis A virus.

• Echovirus.

• Influenza virus.

• Enterovirus.

• Herpes simplex virus.

• Human immunodeficiency virus or HIV.

• HHV -6.

• Parvovirus B19.

• Parainfluenza virus.

• Mumps.

• Poxvirus.

• Rotavirus.

• Respiratory syncytial virus.

• Vaccination of Calmette - Guerin bacillus.

• Vaccine for diphtheria - pertussis- tetanus.

• Poliomyelitis vaccination.

• Japanese encephalitis vaccination.

• Hepatitis and measles vaccination.

• Atopic dermatitis.

What Are the Symptoms of Gianotti-Crosti Syndrome?

The symptoms of Gianotti-Crosti syndrome lasted for three to four weeks and resolved independently. The symptoms of Gianotti-Crosti syndrome are acute and follow a symmetrical distribution. Gianotti-Crosti syndrome is more prevalent in summer and spring conditions. The commonly affected areas of Gianotti-Crosti syndrome are the external surface of the upper extremities, legs, face, and buttocks region. The various signs and symptoms of Gianotti-Crosti syndrome are mentioned below:

• Papules are flat-topped.

• Skis blisters are present.

• The size of the skin lesions ranges from one to ten millimeters.

• Pale pink to flesh color skin lesions are present.

• Vesicular lesions and bleeding are rarely present.

• Skin lesions are discrete and firm.

• The lesions in areas like knees and elbows under overpressure become confluent.

• The Koebner phenomenon is present.

• Pruritus is present.

• Other systemic symptoms of Gianotti-Crosti syndrome are mentioned below.

• Fever.

• Lymphadenitis.

• Hepatosplenomegaly is called enlargement of the liver and spleen.

• Pharyngitis.

What Are the Disorders Associated With Gianotti-Crosti Syndrome?

Some of the disorders are usually associated with Gianotti-Crosti Syndrome. The related disorders that occur in association with Gianotti-Crosti Syndrome are mentioned below:

• Hepatitis B virus, or HBV, is characterized by fever, severe vomiting, jaundice, and nausea.

• Coxsackie virus, the symptoms include sore throat, fever, severe headache, and abdominal rash.

• Cytomegalovirus, or CMV, is characterized by hepatitis, fever, and liver damage.

• Infection mononucleosis is caused by the Ebstein-Barr virus.

What Is the Diagnosis of Gianotti-Crosti Syndrome?

The diagnosis is primarily based on the physical examination and history of an underlying viral infection such as hepatitis. The various other diagnostic tools for diagnosing Gianotti-Crosti syndrome are mentioned below:

• History of the patient.

• Medical history.

• History of vaccination.

• Physical examination of the symptoms.

• Evaluation of viruses.

• Skin biopsy.

What Is the Differential Diagnosis of Gianotti-Crosti Syndrome?

The symptoms of Gianotti-Crosti syndrome are due to the virus and should not be misdiagnosed with another type of skin lesion. Some of the differential diagnoses of Gianotti-Crosti syndrome are mentioned below:

• Viral exanthema (eruptive skin rash that is usually related to a viral infection. Immunizations have reduced the number of cases of mumps, measles, rubella, and chickenpox. However, all viral skin infections need clinical care by a physician or other healthcare professional).

• Erythema infectiosum (a benign childhood condition that causes a classic slapped-cheek appearance).

• Hand-foot-mouth disease.

• Insect bites.

• Scabies.

• Atopic dermatitis.

• Papular urticaria.

• Erythema multiforme.

• Langerhans cell histiocytosis.

• IgA vasculitis.

• Lichenoid dermatosis.

What Is the Treatment of Gianotti-Crosti Syndrome?

Gianotti-Crosti syndrome is a benign self-limiting skin condition, and the symptoms will last for three to four weeks and be resolved independently. Supportive management is given to the children affected with Gianotti-Crosti syndrome. The various treatment modes for treating Gianotti-Crosti syndrome are given below:

• Topical emollients are applied to relieve painful itching.

• Oral antihistamines can be administered.

• In addition to emollients and oral antihistamines, topical steroids are advised.

The treatment of children affected with this condition is mainly symptomatic and supportive, as Gianotti-Crosti Syndrome is a self-limiting disorder. In some cases, the use of topical ointments or some medications by mouth might be recommended to help increase mild to potentially severe pruritus or itching.

The skin lesions associated with Gianotti-Crosti Syndrome usually resolve on their own within around 15 to 60 days. When associated findings show enlargement of the lymph nodes or lymphadenopathy and enlargement of the liver (related to liver inflammation). These findings might continue for several months after initial symptom onset.

Conclusion

Gianotti-Crosti syndrome, or papular acrodermatitis in childhood, is a benign skin condition characterized by pink to flesh-colored skin lesions. Gianotti-Crosti syndrome most commonly affects children aged five months to nine years. Gianotti-Crosti syndrome symptoms include itching rash, blisters, and bumps with mild to moderate pruritis in the upper extremities, buttocks, face, and legs. It is suggested that the Gianotti-Crosti syndrome will be preceded by Val infection and other predisposing factors. Early diagnosis is made with a physical examination, and supportive management is given. However, Gianotti-Crosti syndrome symptoms will be resolved independently, and the prognosis is not bad. The recurrence rate of Gianotti-Crosti syndrome is rare.