ABSTRACT
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.
ABSTRACT
Gianotti-Crosti syndrome (GCS) is a sporadic dermatosis affecting mainly children. It is characterized by multiple, confluent, monomorphic and pruritic pink to red-brown papules or papulovesicles, distributed symmetrically on the face, extensor surfaces of the extremities and buttocks, commonly sparing the trunk, palms and soles. This can be preceded by a viral infection, and may be accompanied by fever, hepatosplenomegaly, or lymphadenopathy. Personal and family history of atopy appears to be a risk factor in the subsequent development of GCS, thus frequently diagnosed as atopic dermatitis. We report a case of a 4-year-old boy from our institution with generalized, pruritic, papulovesicular rashes on the face and extremities for one month. He was diagnosed to have atopic dermatitis and treated as such, before presentation to our institution. As the signs and symptoms in GCS are similar to atopic dermatitis, we suggest that this diagnosis be considered when presented with a similar case.
Subject(s)
Child , Child, Preschool , Humans , Male , Acrodermatitis , Buttocks , Dermatitis, Atopic , Diagnosis , Exanthema , Extremities , Fever , Hypersensitivity , Lymphatic Diseases , Risk Factors , Skin DiseasesABSTRACT
El síndrome de Gianotti-Crosti, también llamado acrodermatitis papular de la infancia, es un exantema infrecuente de la infancia, que se presenta generalmente en niños entre 1 y 6 años de edad. Dado que estos pacientes generalmente son llevados a su pediatra, es fundamental el conocimiento de las características de este síndrome. El cuadro clínico se caracteriza por una reacción pápulo-vesicular asintomática y autolimitada de distribución simétrica en cara, nalgas y superficies extensoras de las extremidades, formando placas o permaneciendo aisladas. El tronco generalmente se encuentra respetado y las lesiones usualmente no son pruriginosas. Se reportan los casos de dos pacientes que consultaron en el Servicio de Dermatología de la Pontificia Universidad Católica de Chile, por un cuadro compatible con síndrome de Gianotti-Crosti. A propósito de los casos, se presentan los aspectos más relevantes sobre esta patología.
The Gianotti-Crosti syndrome, also known as papular acrodermatitis of childhood, is an uncommon rash that usually occurs in children between 1 and 6 years old. Given that these patients are usually brought to their pediatrician, it is essential to know the characteristics of this syndrome. The clinical picture is characterized by a self-limited and asymptomatic papulo-vesicular reaction, symmetrically distributed on the face, buttocks and extensor surfaces of the extremities. The trunk is generally respected and the lesions are usually not itchy. We report the cases of two patients treated at the Dermatology Department at the Pontificia Universidad Católica de Chile, with symptoms consistent with Gianotti-Crosti syndrome. We also present the most relevant aspects of this disease.
Subject(s)
Humans , Female , Infant , Child , Acrodermatitis/diagnosis , Acrodermatitis/etiology , Exanthema , Remission, SpontaneousABSTRACT
Gianotti-Crosti syndrome (GCS) is a relatively common skin disorder characterized by a distinctive, self-limiting, non-recurrent erythematous or skin-colored papulovesicular eruption. It mainly affects the extremities, buttocks and face. It commonly occurs in infants, young children and, infrequently, in adults. GCS following immunization has already been described with DTP, MMR, BCG, oral polio and influenza vaccinations. We report a case of GCS in an 18 month-old boy. He had suffered from symmetrical, flat-topped, erythematous papules on the face, buttocks, and extensor surfaces of extremities for 10 days. He had received a hepatitis A vaccination 1 month ago. Otherwise, there was no noticeable past history. The viral markers were all negative and other laboratory findings including liver function tests were within normal range. The skin lesions disappeared after conservative treatment. We, herein, report a case of GCS, of which hepatitis A vaccination might be a possible cause.
Subject(s)
Adult , Child , Humans , Infant , Acrodermatitis , Biomarkers , Buttocks , Extremities , Hepatitis , Hepatitis A , Immunization , Influenza, Human , Liver Function Tests , Mycobacterium bovis , Poliomyelitis , Reference Values , Skin , VaccinationABSTRACT
We report a three-year-old Korean boy who presented with itching symmetrical erythematous macules and papules on his face, trunk, and extremities for 1 week. Lymphadenopathies were detected on physical examination. He was vaccinated against Japanese B Encephalitis (JE) 1 day before developing skin rashes. The patient's serum JE antibody titer by hemagglutinin inhibition (HI) test was 1:40. Under the diagnosis of Gianotti-Crosti syndrome following JE vaccination, he was conservatively treated with an antihistamine agent, and his symptoms were all cleared 2 weeks after treatment.
Subject(s)
Child, Preschool , Humans , Male , Acrodermatitis/etiology , Encephalitis, Japanese/prevention & control , Japanese Encephalitis Vaccines/adverse effectsABSTRACT
Gianotti-Crosti syndrome(GCS) is a distinct exanthematic, acrolocated eruption of childhood caused by a variety of infectious agents. Historically hepatitis B antigen positive(HBsAG+) papular acrodermatitis of childhood and HBsAg negative(HBsAg-) papulovesicular acrolocated syndrome have been distinguished. Here we present a 22-month-old female patient who developed eruptions typical for GCS and showed serologic evidence of an acute Epstein-Barr virus(EBV) infection. Serologic investigations revealed no evidence of recent infection with most common viruses except EBV infection. This case suggests that EBV infection should be sought in cases of GCS which cannot be related to HBV infection.
Subject(s)
Female , Humans , Infant , Acrodermatitis , Epstein-Barr Virus Infections , Hepatitis B , Hepatitis B Surface Antigens , Herpesvirus 4, HumanABSTRACT
We report herein a case of Gianotti-Crosti syndrome showing unusual features. A 12-month-old male patient presented with papular skin lesions on his face and papulovesicular skin lesions on the trunk, upper and lower extremities, which were distributed symmetrically. Three days before the skin eruptions, he had been immunized with a measles vaccination. Serologically, antigens of the type B hepatitis virus and antibodies to coxsackie virus B-4, Epstein-Barr virus, and varicella-zoster virus were all negative and antibodies to the measles virus (IgG, IgM) and the type B hepatitis virus were positive. After conservative treatment the skin lesions subsided with exfoliation within 4 weeks. An association with the measles vaccination and the initial papulovesicular skin lesions are considered as peculiar features of this case.