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Gianotti–Crosti syndrome (papular acrodermatitis of childhood) in the era of a viral recrudescence and vaccine opposition

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Abstract

Background

Gianotti–Crosti syndrome is characterized by an acute onset of a papular or papulovesicular eruption with a symmetrical distribution.

Data sources

A PubMed search was conducted using Clinical Queries with the key terms “Gianotti-Crosti syndrome” OR “papular acrodermatitis”. The search strategy included meta-analyses, randomized controlled trials, clinical trials, observational studies, and reviews. This paper is based on, but not limited to, the search results.

Results

The eruption of Gianotti–Crosti syndrome is found predominantly on the cheeks, extensor surfaces of the extremities, and buttocks. There is a sparing of antecubital and popliteal fossae as well as palms, soles, and mucosal surfaces. Although often asymptomatic, the lesions may be mildly to moderately pruritic. Gianotti–Crosti syndrome is most common in children between 1 and 6 years of age. The Epstein–Barr virus and the hepatitis B virus are the most common pathogens associated with Gianotti–Crosti syndrome. No treatment for Gianotti–Crosti syndrome is necessary because it is self-limited. In an era of vaccine hesitancy and refusal, Gianotti–Crosti syndrome may be important to mention to parents, because it can occur and trigger alarmism.

Conclusions

Gianotti–Crosti syndrome is mainly a disease of early childhood, characterized by an acute onset of a papular or papulovesicular eruption with a symmetrical distribution. With the advent of more universal vaccination against hepatitis B virus, Epstein–Barr virus has become the most common etiologic agent of Gianotti–Crosti syndrome. Few cases of post-vaccination Gianotti–Crosti syndrome have been reported. Currently, the emphasis should be placed on its self-limiting attribution.

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Authors and Affiliations

  1. Department of Pediatrics, The University of Calgary, Calgary, Canada

    Alexander K. C. Leung

  2. The Alberta Children’s Hospital, #200, 233-16th Avenue NW, Calgary, AB, T2M 0H5, Canada

    Alexander K. C. Leung

  3. The University of Alberta, Edmonton, AB, Canada

    Consolato Maria Sergi

  4. Departments of Pediatrics, Dermatology and Skin Sciences, University of British Columbia, Vancouver, BC, Canada

    Joseph M. Lam

  5. Pediatric Institute, Kuala Lumpur General Hospital, Kuala Lumpur, Malaysia

    Kin Fon Leong

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AKCL wrote the first draft of the manuscript, as well as a statement of whether an honorarium, grant, or other form of payment was given to anyone to produce the manuscript. CMS, JML, and KFL contributed to drafting and revising the manuscript. The authors have seen and approved the final version submitted for publication and take full responsibility for the manuscript.

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Correspondence to Alexander K. C. Leung.

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Leung, A.K.C., Sergi, C.M., Lam, J.M. et al. Gianotti–Crosti syndrome (papular acrodermatitis of childhood) in the era of a viral recrudescence and vaccine opposition. World J Pediatr 15, 521–527 (2019). https://doi.org/10.1007/s12519-019-00269-9

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