Gianotti-Crosti Syndrome Research Articles

Erythema nodosum in Gianotti–Crosti syndrome associated with cytomegalovirus infection: a case report

Erythema nodosum in Gianotti–Crosti syndrome associated with cytomegalovirus infection: a case report

A case with Gianotti-Crosti syndrome with a history of atopic dermatitis

Gianotti-Crosti syndrome (GCS) is characterized by the sudden onset of a papular or papulovesicular rash with a symmetrical distribution. This rash mainly appears on the extensor surfaces of the limbs, buttocks, and face. GCS is most frequently observed in children aged 1 to 6 years. In this case, we present the diagnosis of GCS in an 8-month-old male patient who also has a history of atopic dermatitis. Symmetrical, multiple, monomorphic, raised, red, and itchy lesions were identified on the patient’s face, trunk, arms, and legs. The presence of atopic dermatitis was notably more common in individuals with GCS, suggesting a significant association with a family history of atopy. GCS is a syndrome that demands a high degree of clinical suspicion as it can be mistaken for other childhood exanthematous diseases.

New exanthematous desease in pediatrics

Exanthems do not represent a disease per se, but they are the most clinically useful manifestation for the arrival of the diagnosis of the disease for the physician, as well as the most common cause that brings patients to the consultation. Regarding new pediatric exanthems, it is important to consider the age of onset since they tend to manifest after the first year of the individual's life, while up to 12 months, their epidemiology is usually limited to the well-known classics such as measles, sudden rash, rubella, chickenpox, Kawasaki disease, Coxsackie virus, meningococcemia, echovirus, among others. (1) Classic exanthematous diseases have been known for a long time and have been classified in sequential order. The first and second refer to scarlet fever and measles. Rubella is the third. The exanthem caused by staphylococcal epidermolytic toxin is the fourth. Erythema infectiosum is the fifth, and sudden rash is the sixth disease. In recent decades, new tools and methodologies based on four forms of investigation through clinical studies, laboratory studies, epidemiological studies, and clinical trials including the validation of new and more specific diagnostic criteria, such as procedures for the detection of viral genetic sequences such as PCR, viral load, and antibody affinities, as well as exhaustive epidemiological analyses in patient groups of different ages, nationalities, and skin types, have led to the diagnosis of new exanthematous diseases known as pityriasis rosea (PR), Gianotti-Crosti syndrome (GCS), asymmetric periflexural exanthem/unilateral laterothoracic exanthem (APE/ULE), gloves and socks syndrome (PPGSS), eruptive pseudoangiomatosis (EP), and eruptive hypomelanosis (EH). (2) Background:(Complete here). Material and methods: (Different case repot were analyzed in relation to the available literature in virtual libraries such as PubMed and cited by the Argentine Society of pediatrics). Results: (The systematic review of new rashes manifested mostly in the pediatric population increasingly suggest their viral etiology as well as their low risk of serious systemic complications. Determining their characteristics, chronology and topography as well as the physician´s experience shead diagnostic light on daily clinical practice). Conclusion: (The epidemiological and histopathological analysis of the lesion and clinical methods of diagnosing these rashes has been intense over the past 30 years, although their observation remains key to the increasingly accurate determination of their etiology, which is still subject to refinement and discussion

Gianotti-Crosti syndrome mimicking scabies.

This case report highlights a case of a 65-year-old woman who presented to our clinic with suspicion of refractory scabies. She had undergone multiple treatments without improvement. However, the clinical condition was not scabies but rather Gianotti-Crosti Syndrome (GCS), leading to rapid clinical improvement and avoiding the need for further unnecessary tests and treatments. GCS is a postviral exanthem characterized by symmetrical, red papules on the extremities and buttocks, typically occurring in children but can also affect adults. It is crucial for every physician to distinguish it from other causes of rash, including scabies, to ensure an accurate diagnosis and appropriate management.

Successful revaccination of a child with Gianotti-Crosti syndrome following diphtheria tetanus and rabies vaccinations.

Successful revaccination of a child with Gianotti-Crosti syndrome following diphtheria tetanus and rabies vaccinations.

Клінічний випадок папульозного акродерматиту або синдрому Джанотта-Крості

Gianotti-Crosti syndrome is a kind of infectious exanthem. That is characterized by the appearance of monomorphic papules, which colour may be from the skin colour to pink-red ones. The most typical location is on the face, buttocks and extensor surfaces of the limbs. Over time, the rash disappears spontaneously and the medical treatment becomes symptomatic. Currently, the pathophysiological changes are not still thoroughly studied. It is clear that the syndrome represents an immunological response to the previous viremia and bacteraemia; perhaps, it is the delayed-type hypersensitivity reaction. Purpose - to acquaint doctors with criteria of the papular acrodermatitis for a timely diagnostic and a correct treatment strategy. Clinical case. There was a described clinical case of Gianotti-Crosti syndrome in a child of 2. The parents had complained about rashes on the face, limbs, buttocks for 6 weeks. The severe restlessness and itching of the skin had been present. During the whole time, the child was examined by various specialists. Alternative diagnoses were: an atopic dermatitis, a food allergy, a worm infestation. The child was prescribed local zinc-containing agents, systemic and local glucocorticosteroids, antiviral drugs, antibacterial therapy, antihistamines, sorbents, probiotics and a three-time course of deworming in the process of the treatment. The treatment have not had a positive therapeutic effect. Conclusions. Gianotti-Crosti syndrome is most common in childhood. At present, we consider it a self-limited disease that does not require specific treatment. Recent studies proved that the syndrome is more commonly associated with a variety of viral and bacterial pathogens. However, insufficient knowledge of papular acrodermatitis may lead to groundless and continuous examinations and treatment of children. The research was carried out in accordance with the principles of the Helsinki Declaration. The informed consent of the patient was obtained for conducting the studies. No conflict of interests was declared by the authors.

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.

Viral exanthems in children

Virale und paravirale Exantheme sind die häufigsten Exantheme des Kindesalters, die auch meist zu einer Vorstellung in der Praxis inklusive der Notaufnahme führen. Die Kenntnis der verschiedenen Krankheitsbilder ist entscheidend für die adäquate Diagnostik und Betreuung der kleinen Patient:innen, die entsprechende Aufklärung der Familie und ggf. das Minimieren des Infektionsrisikos. In der aktuellen Arbeit werden die kürzlich beschriebenen „reactive infectious mucocutaneous eruptions“ (RIME) und das „pediatric inflammatory multisystem syndrome“ (PIMS) vorgestellt. Zusätzlich werden wir einige atypische Manifestationen des Gianotti-Crosti-Syndroms und der Hand-Fuß-Mund-Erkrankung – wie z. B. die mit Mollusken assoziierte „Gianotti-Crosti-like reaction“ und das „eczema coxsackium“ – erläutern.

Gianotti-Crosti syndrome: exanthema following a vaccination

<p class="abstract">Gianotti-Crosti syndrome (GCS) is a benign skin disorder characterized by self-limiting acute exanthema. Commonly preceding with the infection of viruses or bacteria and vaccinations. Usually affects children aged 1-6 years and is associated with atopic disease. The exact of GCS incidence is unknown, although several countries in the world have been reported GCS cases. Vaccine-induced GCS cases are infrequently reported. The diagnosis can be made clinically based on clinical features and vaccination history. Treatment is generally symptomatic. Education about GCS is important to prevent over-treatment and avoidance of vaccination in the future. We reported a 9-month-old baby with symmetrical bilateral monomorphic multiple dome-shaped papules lesions on the extremities two days following vaccination.</p>

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

IntroductionSkin 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.MethodologyAn 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.ResultsIn 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.ConclusionPapulosquamous 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.

A Fatal Case of Febrile Ulceronecrotic Mucha-Habermann Disease in a 10-Year-Old Boy.

A Fatal Case of Febrile Ulceronecrotic Mucha-Habermann Disease in a 10-Year-Old Boy.

Gianotti-Crosti Syndrome in a Child with Recent Covid-19 Infection: A Case Report

Gianotti-Crosti Syndrome is a rare skin disease affecting children at the first years of age. The condition is clinically featured by blisters on the skin of the legs, buttocks and arms. A history of viral infection preceding the disease was reported for many cases. A 12-month-old boy, free of any medical illnesses, was presented with a history of acute-onset rash for five days prior to presentation that was preceded by a history of fever for two days then subsided. The rashes appeared initially on his buttocks, then spread to his upper and lower extremities and trunk. The child had fever, sore throat and coryza symptoms with lethargy. A polymerase chain reaction (PCR) swab was taken to test for SARS-CoV-2, which was positive two weeks before rash onset. All symptoms resolved in 1 week with supportive therapy and the current rashes appeared two weeks later in the patient. Gianotti–Crosti syndrome may follow the active phase of infection for some cases. It should not be misdiagnosed with dermatological simple eruptive disorders. The clinical features for covid-19 associated infection are typical for the well-known clinical picture of the syndrome. The case was reported to improve clinicians’ awareness and help in better understanding and reporting cutaneous manifestations of COVID-19. Keywords: Gianotti-Crosti Syndrome; Infants; Children; covid-19; Corona

Polyuria, Polydipsia and Papules in a 9-Year-Old Girl: A Case Report

Eruptive xanthomas can be cutaneous manifestations of hypertriglyceridemia but are commonly misdiagnosed as molluscum contagiosum. They appear as yellow papules without an umbilicated surface and have a broad differential. One benign etiology is papular acrodermatitis of childhood (Gianotti-Crosti syndrome) that may develop after several different viral illnesses and may be of similar size, number and location as eruptive xanthomas. Juvenile xanthogranulomas are another diagnostic differential but are more often a single lesion. When multiple xanthogranulomas are present, the clinician should look for NF-1 associated with hematologic malignancy. Pruritus is not a typical feature and, if present, should prompt further investigations, specifically to rule out cholestasis. Finally, xanthomas may also present with newly diagnosed diabetes mellitus as insulin is a key component of lipid metabolism. In such cases, eruptive xanthomas should be expected to resolve with adequate diabetic control, when presenting concomitantly; however, adult patients may require medical therapy.

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

SummaryBackground and objectivesMolluscum 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 methodsRetrospective chart review of all children presenting with GCLR at our Pediatric Skin Center between 2015 and 2020.Results26 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.ConclusionsGCLR 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.

GIANOTTI-CROSTI SYNDROME

We present a case of a 3 years and 8 months old female child with a generalized maculoerythematous rash associated with positive serologies for Epstein Barr virus, Echovirus and Coxsackie that raise suspicion of GianottiCrosti syndrome. The extremely low prevalence of this syndrome and the very long duration of the disease are highlighted, the rash can persist for up to 4 months. We discuss this case both in order to make health professionals aware of the existence of this rare condition, which should be considered in the differential diagnosis of a viral rash, and to educate the community (school, kindergarten) that tends to isolate affected children during persistence of the rash, which is considered contagious.

Acute adverse reaction to self-prescribed potassium hydroxide 5% solution in a child with papular acrodermatitis of childhood.

article: Acute adverse reaction to self-prescribed potassium hydroxide 5% solution in a child with papular acrodermatitis of childhood - Italian Journal of Dermatology and Venereology 2021 Jun 23 - Minerva Medica - Journals

In Memory of Raffaele Gianotti

Prof. Raffaele Gianotti (“Raf” for friends) was born on July 7th,1959 in Milan (Italy). His father, Prof. Ferdinando Gianotti (1920-1984), was a famous pediatric dermatologist that gave his name to the “papular acrodermatitis of childhood” (Gianotti-Crosti Syndrome) [...].

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.

Risk of scarring in Gianotti-Crosti Syndrome.

Risk of scarring in Gianotti-Crosti Syndrome.

Dermatological diseases associated with Hepatitis B virus infection

Hepatitis B virus (HBV) infection is a critical public health issue worldwide. The prompt recognition of skin diseases associated with HBV enables the earlier diagnosis of undetected HBV infection. This review article aims to provide a guide for physicians to increase awareness of possible HBV infection when encountering skin diseases. The frequencies of HBV infection were highest in telangiectasia macularis multiplex acquisita, followed by mixed cryoglobulinemia (MC), polyarteritis nodosa (PAN), and Gianotti-Crosti syndrome (GCS). Serology tests for HBV are recommended for patients with the above diseases. Lichen planus is not associated with HBV according to the most recent evidence. Chronic urticaria and porphyria cutanea tarda are associated with HBV infection although the detection rate of HBV was only 2% in these two diseases. The mechanism behind the associations between HBV and these skin disorders remains unknown and virus-associated immune-mediated processes or direct injury caused by viral replication are frequently proposed. The clinical manifestation was not discrepant between the HBV-associated skin disorder and the non-HBV-associated counterpart. The duration of HBV infection did not show any statistically significant correlations with the development of skin disorders. Antiviral medication yielded improvement in HBV-associated PAN, MC and GCS.