Gianotti-Crosti syndrome

Health care providers don't know the exact cause of this disorder. They do know that it is linked with other infections.

In Italian children, Gianotti-Crosti syndrome is seen frequently with hepatitis B infection. But this link is rarely seen in the United States. Epstein-Barr virus (EBV, mononucleosis) is the virus most often associated with acrodermatitis.

Other associated viruses include:

• Cytomegalovirus
• Coxsackie viruses
• Parainfluenza virus
• Respiratory syncytial virus (RSV)
• Some types of live virus vaccines

Skin symptoms may include any of the following:

• Rash or patch on the skin, usually on the arms and legs
• Brownish-red or copper-colored patch that is firm and flat on top
• String of bumps may appear in a line
• Generally not itchy
• Rash looks the same on both sides of the body
• Rash may appear on the palms and soles, but not on the back, chest, or belly area (this is one of the ways it is identified, by the absence of the rash on the trunk of the body)

Other symptoms that may appear include:

• Swollen abdomen
• Swollen lymph nodes
• Tender lymph nodes

Your provider can diagnose this condition by looking at your skin and rash. Your liver, spleen, and lymph nodes may be swollen.

The following tests may be done to confirm the diagnosis or rule out other conditions:

• Bilirubin level
• Hepatitis virus serology or hepatitis B surface antigen
• Liver enzymes (liver function tests)
• Screening for EBV antibodies
• Skin biopsy

The disorder itself is not treated. Infections linked with this condition, such as hepatitis B and Epstein-Barr, are treated. Cortisone creams and oral antihistamines may help with itching and irritation.

The rash usually disappears on its own in about 3 to 8 weeks without treatment or complication. Associated conditions must be watched carefully.

Complications occur as a result of associated conditions, rather than as a result of the rash.

Call your provider if your child has signs of this condition.

Papular acrodermatitis of childhood; Infantile acrodermatitis; Acrodermatitis - infantile lichenoid; Acrodermatitis - papular infantile; Papulovesicular acro-located syndrome

Bender NR, Chiu YE. Eczematous disorders. In: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Textbook of Pediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020:chap 674.

Zawar V, Chuh AAT. Gianotti-Crosti syndrome. In: Lebwohl MG, Heymann WR, Coulson IH, Murrell DF, eds. Treatment of Skin Disease: Comprehensive Therapeutic Strategies. 6th ed. Philadelphia, PA: Elsevier; 2022:chap 91.

Updated by: Ramin Fathi, MD, FAAD, Director, Phoenix Surgical Dermatology Group, Phoenix, AZ. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.