Gianotti-Crosti Syndrome

Flesh-colored to red-brown nonpruritic papules developed most prominently on the elbows, forearms, and knees of a 2 1⁄2-year-old boy. The rash was preceded by a low-grade fever and mild, upper respiratory tract symptoms.

On physical examination, no hepatosplenomegaly was detected. A clinical diagnosis of Gianotti-Crosti syndrome, or papular acrodermatitis, was made by Drs Charles E. Crutchfield III and Humberto Gallego of Eagan, Minn.

Gianotti-Crosti syndrome is self-limited. It is seen in children, particularly youngsters between 2 and 5 years of age who have viral infections, including those caused by Epstein-Barr virus, coxsackievirus, and hepatitis B virus. If hepatic symptoms are present at the initial diagnosis, reexamine the child in 4 to 6 weeks; patients without liver involvement need routine follow-up to monitor for the development of hepatic disorders.

Mild postinflammatory hyperpigmentation may follow rash resolution; generally, it will fade in a few months. Corticosteroids usually are of no benefit in treating this condition. Reassure the patient (and parents) that the disease is self-limited and will resolve in approximately 2 months. This young boy's symptoms cleared 7 weeks after they first appeared.