Gianotti–Crosti syndrome mainly affects infants and young children. Children of age as low as 1.5 months and up to 12 years of age are reported to be affected. 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. 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.
The diagnosis of Gianotti–Crosti syndrome is clinical. A validated diagnostic criteria is as follows:
A patient is diagnosed as having Gianotti–Crosti syndrome if:
On at least one occasion or clinical encounter, he/she exhibits all the positive clinical features,
On all occasions or clinical encounters related to the rash, he/she does not exhibit any of the negative clinical features,
None of the differential diagnoses is considered to be more likely than Gianotti–Crosti syndrome on clinical judgment, and
If lesional biopsy is performed, the histopathological findings are consistent with Gianotti–Crosti syndrome.
The positive clinical features are:
Monomorphous, flat-topped, pink-brown papules or papulovesicles 1-10mm in diameter.
At least three of the following four sites involved – (1) cheeks, (2) buttocks, (3) extensor surfaces of forearms, and (4) extensor surfaces of legs.
Gianotti-Crosti disease is a harmless and self-limiting condition, so no treatment may be required. 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.
^Michitaka K, Horiike N, Chen Y, et al. (August 2004). "Gianotti-Crosti syndrome caused by acute hepatitis B virus genotype D infection". Internal Medicine (Tokyo, Japan)43 (8): 696–9. doi:10.2169/internalmedicine.43.696. PMID15468968.
^Haki M, Tsuchida M, Kotsuji M, et al. (October 1997). "Gianotti-Crosti syndrome associated with cytomegalovirus antigenemia after bone marrow transplantation". Bone Marrow Transplantation20 (8): 691–3. doi:10.1038/sj.bmt.1700945. PMID9383234.
^Chandrasekaran M, Mukherjee S (September 2007). "Gianotti Crosti syndrome". Indian Pediatrics44 (9): 695. PMID17921560.
^ abChuh, AA (September 2001). "Diagnostic criteria for Gianotti-Crosti syndrome: a prospective case-control study for validity assessment.". Cutis; cutaneous medicine for the practitioner68 (3): 207–13. PMID11579787.
^ abChuh, Antonio; Lee, Albert; Zawar, Vijay (1 September 2004). "The Diagnostic Criteria of Gianotti-Crosti Syndrome: Are They Applicable to Children in India?". Pediatric Dermatology21 (5): 542–547. doi:10.1111/j.0736-8046.2004.21503.x. PMID15461758.
^ abChuh, Antonio; Zawar, Vijay; Law, Michelle; Sciallis, Gabriel (2 January 2012). "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". Infectious Disease Reports4 (1). doi:10.4081/idr.2012.e12. PMID24470919.