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| __NOTOC__
| | #Redirect [[Infantile papular acrodermatitis]] |
| {{SI}}
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| {{Infobox Disease |
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| Name = Gianotti–Crosti syndrome |
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| Image = |
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| Caption = |
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| DiseasesDB = 32236 |
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| ICD10 = {{ICD10|L|44|4|l|40}} ([[ILDS]] L44.400) |
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| ICD9 = {{ICD9|057.8}} |
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| ICDO = |
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| OMIM = |
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| MedlinePlus = |
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| eMedicineSubj = derm |
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| eMedicineTopic = 165 |
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| MeshID = D000169 |
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| }}
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| {{CMG}}
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| {{SK}} Infantile papular acrodermatitis, Papulovesicular acrolocated syndrome, Papular acrodermatitis of childhood.
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| ==Overview==
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| Gianotti–Crosti syndrome is a reaction of the skin to a viral infection.<ref name="urlGianotti-crosti syndrome, papulovesicular acrodermatitis. DermNet NZ">{{cite web |url=http://dermnetnz.org/viral/gianotti-crosti.html |title=Gianotti-crosti syndrome, papulovesicular acrodermatitis. DermNet NZ |work= |accessdate=}}</ref> [[Hepatitis B]]<ref name="pmid15468968">{{cite journal | author = Michitaka K, Horiike N, Chen Y, ''et al.'' | title = Gianotti-Crosti syndrome caused by acute hepatitis B virus genotype D infection | journal = Internal Medicine (Tokyo, Japan) | volume = 43 | issue = 8 | pages = 696–9 | year = 2004 | month = August | pmid = 15468968 | doi = | url = | issn = }}</ref> and [[Epstein-Barr virus]] are the most frequently reported etiologies. Other incriminated viruses are [[hepatitis A]], hepatitis non A-non B, [[cytomegalovirus]],<ref name="pmid9383234">{{cite journal | author = Haki M, Tsuchida M, Kotsuji M, ''et al.'' | title = Gianotti-Crosti syndrome associated with cytomegalovirus antigenemia after bone marrow transplantation | journal = Bone Marrow Transplantation | volume = 20 | issue = 8 | pages = 691–3 | year = 1997 | month = October | pmid = 9383234 | doi = 10.1038/sj.bmt.1700945 | url = | issn = }}</ref> [[coxsackie]], [[adenovirus]], [[enterovirus]], [[rotavirus]], [[rubella]], [[HIV]] and [[parainfluenza]].<ref name="pmid17921560">{{cite journal | author = Chandrasekaran M, Mukherjee S | title = Gianotti Crosti syndrome | journal = Indian Pediatrics | volume = 44 | issue = 9 | pages = 695 | year = 2007 | month = September | pmid = 17921560 | doi = | url = | issn = }}</ref> It is named for [[Ferdinando Gianotti]] and [[Agostino Crosti]].<ref>{{WhoNamedIt|synd|4051}}</ref><ref name="pmid13500859">{{cite journal |author=CROSTI A, GIANOTTI F |title=[Eruptive dermatosis of probable viral origin situated on the acra.] |language=French |journal=Dermatologica |volume=115 |issue=5 |pages=671–7 |year=1957 |month=November |pmid=13500859 |doi= |url=}}</ref>
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| ==Clinical features and diagnosis==
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| Gianotti–Crosti syndrome mainly affects infants and young children. Children of age as low as 1.5 months is reported to be affected.<ref name="Sarma 2013 65–67">{{cite journal|last=Sarma|first=N|coauthors=Sarkar UK|title=Hemorrhagic Gianotti-Crosti Syndrome in a One and Half Month old Infant: An Extremely Unusual Presentation|journal=Ind J Dermatol|year=2013|month=Jan-Mar|volume=58|issue=1|pages=65–67|doi=10.4103/0019-5154.105313|url=http://www.e-ijd.org/article.asp?issn=0019-5154;year=2013;volume=58;issue=1;spage=65;epage=67;aulast=Sarma}}</ref> It is generally recognized as a papular or papulovesicular skin rash occurring mainly on the face and distal aspects of the four limbs. Purpura is generally not seen but may develop following application of tourniquet. However extensive purpura without any hemorrhagic disorder has been reported.<ref name="Sarma 2013 65–67"/> The presence of less florid truncal lesions does not exclude the diagnosis. Lymphadenopathy and hepatomegaly are sometimes noted. Raised liver transaminases with no rise in conjugated and unconjugated bilirubin are sometimes detectable, although the absence of such does not exclude the diagnosis. Spontaneous disappearance of the rash usually occurs after 15–60 days.
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| The diagnosis of Gianotti–Crosti syndrome is clinical. A validated diagnostic criteria<ref name = cutis /><ref name = pd /><ref name = idr /> is as follows:
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| A patient is diagnosed as having Gianotti–Crosti syndrome if:
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| 1. On at least one occasion or clinical encounter, he/she exhibits all the '''positive clinical features''',
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| 2. On all occasions or clinical encounters related to the rash, he/she does not exhibit any of the '''negative clinical features''',
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| 3. None of the '''differential diagnoses''' is considered to be more likely than Gianotti–Crosti syndrome on clinical judgment, and
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| 4. If lesional biopsy is performed, the histopathological findings are consistent with Gianotti–Crosti syndrome.
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| The '''positive clinical features''' are:
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| 1. Monomorphous, flat-topped, pink-brown papules or papulovesicles 1-10mm in diameter.
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| 2. At least three of the following four sites involved – (1) cheeks, (2) buttocks, (3) extensor surfaces of forearms, and (4) extensor surfaces of legs.
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| 3. Being symmetrical, and
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| 4. Lasting for at least ten days.
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| The '''negative clinical features''' are:
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| 1. Extensive truncal lesions, and
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| 2. Scaly lesions.
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| The '''differential diagnoses''' are: [[acrodermatitis enteropathica]], [[erythema infectiosum]], [[erythema multiforme]], [[hand-foot-and-mouth disease]], [[Henoch-Schönlein purpura]], [[Kawasaki disease]], [[lichen planus]], [[papular urticaria]], papular purpuric gloves and socks syndrome, and [[scabies]].
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| ==Treatment==
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| Gianotti-Crosti disease is a harmless and self-limiting condition, so no treatment may be required.<ref name="urlGianotti-crosti syndrome. DermaTalk">{{cite web |url=http://www.dermatalk.com/blogs/skin-disorders/gianotti-crosti-syndrome |title=Gianotti-crosti syndrome. Dermatalk }}</ref> Treatment is mainly focused on controlling itching, symptomatic relief and to avoid any further complications. For symptomatic relief from itching, oral [[antihistamines]] or any soothing lotions like calamine lotion or zinc oxide may be used. If there are any associated conditions like streptococcal infections, [[antibiotics]] may be required.<ref name = cutis>Chuh AAT. Diagnostic criteria for Gianotti-Crosti syndrome – a prospective case control study for validity assessment. Cutis 2001; 68: 207-13.</ref>
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| <ref name = pd>Chuh A, Lee A, Zawar V. The diagnostic criteria of Gianotti-Crosti syndrome – are they applicable to children in India? Pediatr Dermatol 2004; 21: 542-7.</ref>
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| <ref name = idr>Chuh A, Zawar V, Law M, Sciallis G. Gianotti-Crosti syndrome, pityriasis rosea, asymmetrical periflexural exanthem, unilateral mediothoracic exanthem, eruptive pseudoangiomatosis and papular-purpuric gloves and socks syndrome: a brief review and arguments for diagnostic criteria. Infect Dis Rep 2012: 4: e12</ref>
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| <ref name="urlGianotti-crosti syndrome. DermaTalk"/>
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| ==References==
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| {{Reflist|2}}
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