Papular acrodermatitis (Gianotti-Crosti syndrome) in a child with anicteric hepatitis B, virus subtype adw

Lyme disease as a cause of acropapular dermatitis of childhood

Acropapular dermatitis of childhood is a symmetric self-limited papulovesicular exanthem that classically occurs on the cheeks, extensor extremities, and buttocks in young children. The eruption of acropapular dermatitis of childhood represents a reaction to a variety of infections usually of viral origin. We present a child with typical findings of acropapular dermatitis of childhood whose serologic workup revealed an acute Lyme infection.

The diagnostic criteria of Gianotti-Crosti syndrome: are they applicable to children in India?

In order to evaluate the applicability of the diagnostic criteria to children with Gianotti-Crosti syndrome (GCS) in India we retrieved all clinical records of children with a definite diagnosis of this syndrome seen over 30 months in a private dermatology practice. The controls were children for whom Gianotti-Crosti had been suspected but the final diagnosis was not this syndrome, and children in whom it was not suspected but who were diagnosed with any of the differential diagnoses of the syndrome. We documented the presence or absence of the positive and negative clinical features for all patients and controls. The clinical records of 23 children with GCS and 74 controls were retrieved. The three positive clinical features--1) papules or papulovesicles 1-10 mm in diameter on at least three of the following four sites: cheeks, buttocks, extensor surfaces of the forearms, extensor surfaces of legs; 2) being symmetrical; 3) lasting for at least 10 days--were sensitive and positively correlated with GCS. Both negative clinical features--extensive truncal lesions and scaly lesions--are negatively correlated with this syndrome. All 23 children with GCS and none of the controls fulfilled the set of diagnostic criteria. We concluded that the Gianotti-Crosti diagnostic criteria are applicable to affected children in India.

Gianotti-Crosti syndrome caused by acute hepatitis B virus genotype D infection

A 12-year-old girl with Gianotti-Crosti syndrome caused by hepatitis B virus (HBV) infection was admitted due to eruption on her extremities. Laboratory findings revealed elevation of transaminase, positivity for HB surface antigen (HBsAg), and an IgM type anti-HB core. The eruption and level of transaminase improved, and HBsAg became negative within 2 months of onset. Analysis of the virus revealed it to be genotype D with a genomic length of 3,182 bases and the HBsAg serotype was ayw3, which is very rare in Japan. The possible relationship between Gianotti-Crosti syndrome and HBV genotype D infection is discussed.

Transient lymphoblastosis and thrombocytopenia in Gianotti-Crosti syndrome

Gianotti-Crosti Syndrome, or papular acrodermatitis of childhood, represents a characteristic rash that is irregularly associated with hepatitis B infection. The authors report papular acrodermatitis in a 10-month-old child with leukopenia, thrombocytopenia, circulating lymphoblasts, and acute anicteric hepatitis B. Physical examination revealed a densely distributed papular rash on the patient's extremities and face and neck, but not on his trunk, buttocks, palms, or soles. Laboratory investigation revealed a normal bone marrow and positive hepatitis B serology. This case reinforces the fact that hematologic findings should not dissuade the work-up of papular acrodermatitis for hepatitis B or other less commonly associated viruses.

Gianotti-Crosti syndrome associated with Epstein-Barr virus infection

Gianotti-Crosti syndrome, a distinctive eruption occurring after hepatitis B infection, is characterized by symmetric, nonpruritic lichenoid papules usually localized to the face, limbs, and buttocks. In North America, hepatitis B antigenemia is rarely associated with Gianotti-Crosti syndrome in infants. Recent reports indicate there are a variety of infectious agents associated with Gianotti-Crosti syndrome. We report a case of an 11-month-old white female infant with Gianotti-Crosti syndrome and concurrent primary Epstein-Barr virus infection without evidence of hepatitis B infection.

Papulosquamous diseases: a review

Papulosquamous diseases are a heterogeneous group of disorders whose etiology primarily is unknown. The nosology of these disorders is based on a descriptive morphology of clinical lesions characterized by scaly papules and plaques. The major entities in this group include psoriasis, parapsoriasis (including pityriasis lichenoides et varioliformis acuta), lichen planus, lichen nitidus, lichen striatus, pityriasis rosea, pityriasis rubra pilaris, seborrheic dermatitis, and the Gianotti-Crosti syndrome. Many other conditions may become papulosquamous and should be considered in the differential diagnosis.