ACEP ID:

Pediatric Emergency Medicine

Case Study Answers-Infant With A Rash

Answer A: Gianotti-Crosti syndrome  

Answer B: This is a reactive skin eruption related to a viral illness.

Answer C: Although many viral infections have been associated with Gianotti Crosti Syndrome, hepatitis B virus and Ebstein Barr virus have been most closely associated with this eruption. Other viral infections such as coxsackie virus, adenovirus, parainfluenza virus, Hepatitis A, and cytomegalovirus are also associated with this.

General Description: Gianotti-Crosti syndrome is a post-viral reactive eruption affecting infants and small children.  It is characterized by papular and vesicular eruptions of the face, buttock, and the distal aspects of the extremities. The trunk is usually spared.  The definitive diagnosis is by biopsy.  Eruptions usually last between 2 to 6 weeks, and resolve without intervention.  Treatment is directed toward controlling pruritis. Oral antihistamines are usually helpful.  In case of secondary infection (usually staphylococcal skin infection), anti-staphylococcal antibiotics are utilized.  Note that Gianotti-Crosti rash can be similar to acrodermatitis enteropathica. Other differential diagnoses of this rash include coxsackie hand foot and mouth disease, Kawasaki’s disease, Henoch Schönlein Purpura, and papular urticaria.

Gianotti-Crosti Syndrome-Image 2

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