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The
Gianotti-Crosti Syndrome. Acrodermatitis de Gianotti-Crosti.
********************************** EDITORIAL ESPAÑOL: ===================== Hola amigos DERMAGICOS, el tema de hoy: ACRODERMATITIS PAPULAR DE LA INFANCIA o SINDROME DE GIANOTTI CROSTI. En el año de 1.955 Gianotti y posteriormente en 1.956, Gianotti y Crosti describieron esta enfermedad cutánea asociada a hepatitis B, con las siguientes características distintivas: 1.) Exantema papular liquenoide no recurrente, simétrico, no pruritico de aparición súbita localizado en cara, miembros y glúteos. 2.) Linfadenopatia leve generalizada. 3.) Hepatitis aguda anicterica, con antigenemia B de superficie. 4.) Niños. 5.) Otras: febrícula, malestar general, y antecedentes de síntomas del tracto respiratorios superior. Y la llamaron ACRODERMATITIS DE LA INFANCIA o ENFERMEDAD DE GIANOTTI-CROSTI. Luego de esta descripción, se presentaron otros casos donde se encontró asociación con otros Agentes VIRALES: Epstein-Barr, Coxsackie, Parvovirus B19, Parainfluenza, Hepatitis A, Rotavirus, Citomegalovirus, HIV, Virus Sincitial Respiratorio (RSV) y Agentes NO VIRALES: Estreptococo Beta Hemolitico del grupo A. También se le denomino: SÍNDROME PAPULOVESICULAR INFANTIL acro-localizado, y ACRODERMATITIS LIQUENOIDE INFANTIL. En el año de 1.977 se describen 3 casos en Adultos. En 1.979 Gianotti hace una revisión del tema y hace una distinción: entre la ENFERMEDAD originalmente descrita, la cual insiste en denominar ACRODERMATITIS DE LA INFANCIA O "ENFERMEDAD" DE GIANOTTI-CROSTI, y todos aquellos otros casos descritos los denomino "SÍNDROME" DE GIANOTTI-CROSTI. Esta controversia persistió varios años, y tal ha sido la confusión que encontramos descripciones de "SÍNDROME" y "ENFERMEDAD" atribuidos a la misma descripción, de una misma patología. Independientemente de que estos investigadores se hayan inmortalizado con este descubrimiento pienso que se deberían UNIFICAR CRITERIOS. Yo propondría llamarla: ACRODERMATITIS DE GIANOTTI-CROSTI O SINDROME DE GIANOTTI-CROSTI, eliminaría el termino "ENFERMEDAD", y agregaría a los criterios originales- Y la ubicaría en el capitulo de las MANIFESTACIONES CUTÁNEAS OCASIONADAS POR AGENTES VIRALES O NO VIRALES. NOTA: Para HOY DÍA 2026 SE UNIFICO EL CRITERIO y la enfermedad es conocida como SÍNDROME DE GIANOTTI-CROSTI o ACRODERMATITIS PAPULAR DE LA INFANCIA, tal como yo lo propuse, y también puede presentarse en adultos. Espero que disfruten estas 41 REFERENCIAS BIBLIOGRÁFICAS. Bienvenido a DERMAGIC/EXPRESS Dr: Joseph Eastern, MD (USA) Saludos a todos !!! Dr. José Lapenta R.,,, EDITORIAL ENGLISH: ===================== Hello DERMAGIC friends , today's topic: THE GIANOTTI CROSTI SYNDROME. In the year of 1.955 Gianotti and later on in 1.956, Gianotti and Crosti they described this cutaneous illness associated to hepatitis B, with the following ones characteristic distinctive: 1.) A non recurrent, symmetric, nonpruritic papular lichenoid exanthem of sudden onset, localized to the face, limbs, and buttocks. 2.) Mild, generalized limphadenopathy. 3.) Acute anicteric hepatitis with hepatitis B surface antigenemia. 4.) Childrens. 5.) Others: Low-grade fever. malaise, and antecedent upper repiratory tract symptoms. And called it ACRODERMATITIS OF THE CHILDHOOD or THE GIANOTTI-CROSTI DISEASE. After this description, other cases were presented in association with other VIRAL Agents: Epstein-Barr, Coxsackie, Parvovirus B19, Parainfluenza, Hepatitis A, Rotavirus, Cytomegalovirus, VIH, Respiratory Syncytial virus (RSV); and NON VIRAL Agents: A Beta-Hemolytic Streptococci. is Also denominated: INFANTILE PAPULOVESICULAR ACRO-LOCALIZED SYNDROME, also: INFANTILE LICHENOID ACRODERMATITIS. In the year of 1.977, 3 cases are described in Adults. In 1.979 Gianotti makes a revision of the topic and he makes a distinction: among the originally described DISEASE which insists on denominating ACRODERMATITIS OF THE CHILDHOOD OR GIANOTTI-CROSTI DISEASE, and all those other described cases he denominate SYNDROME OF GIANOTTI-CROSTI. This controversy persisted for several years, and the consusion was such, that we find descriptions of " SYNDROME " and " DISEASE" attributed to the same description, of the same pathology. Independently that these investigators have been immortalized with this discovery I think that it should BE UNIFIED APPROACHES. I would propose to call it: ACRODERMATITIS OF GIANOTTI-CROSTI, OR GIANOTTI-CROSTI SYNDROME, I would eliminate the term "DISEASE", and would add to the original characteristics. And it would locate it in the chapter of the CUTANEOUS MANIFESTATIONS FOR VIRAL OR NON VIRAL AGENTS. NOTE: By TODAY 2026 THE CRITERIA WAS UNIFIED and the disease is known as GIANOTTI-CROSTI SYNDROME or PAPULAR ACRODERMATITIS OF CHILDHOOD, as I proposed, and it can also occur in adults. I hope you enjoy these 41 BIBLIOGRAPHICAL REFERENCES. WELCOME to DERMAGIC/EXPRESS Dr: Joseph Eastern, MD (USA) Greetings to ALL, !! Dr. José Lapenta R.,,, ================================================================ DERMAGIC/EXPRESS(69) ================================================================ REFERENCIAS BIBLIOGRÁFICAS / BIBLIOGRAPHICAL REFERENCES ================================================================ 1.) Rilievi di una particolare casistica tossinfectiva caratterizzata de eruzione eritemato-infiltrativa desquamativa a focolai lenticolari. a sede electiva acroesposta. 2.) Dermatosis infantile erutiva acroesposta di probable origine virosica. 3.) Gianotti-Crosti syndrome. 4.) Acrodermatitis of chilhood and other papovesicular acro-located Syndromes. 5.) On infantile papular acrodermatitis (Gianotti disease) and infantile papular-similvesicular acrodermatitis (Gianotti syndrome). 6.) Infantile lichenoid acrodermatitis. Report of a case of Gianotti-Crosti syndrome. 7.)Detection of hepatitis B surface antigen subtype adr in an epidemic of papular acrodermatitis of childhood (Gianotti's disease). 8.) Gianotti-Crosti syndrome: clinical, serologic, and therapeutic data from nine children. 9.) [Adult papular acrodermatitis (Gianotti's disease). Report of 3 cases] 10.) A 24 cases of human parvovirus B19 infection in children]. 11.) [An association between hepatitis-B antigen-negative infantile papular acrodermatitis and Epstein-Barr virus infection]. 12.) Gianotti-Crosti syndrome associated with infections other than hepatitis B. 13.) [Infantile acro-localized papulovesicular syndrome]. 14.) Gianotti-Crosti syndrome: a study of 26 cases. 15.) Papular acrodermatitis of childhood associated with hepatitis A virus infection. 16.) [Gianotti-Crosti syndrome. HBsAG-negative papular acrodermatitis, an infantile papulovesicular acrolocalized syndrome]. 17.) [Pediatric papular acrodermatitis and double primary infection by the hepatitis B virus and the Epstein-Barr virus]. 18.) Gianotti-Crosti syndrome. A review of ten cases not associated with hepatitis B. 19.) [Acrodermatitis papulosa eruptiva infantum and Epstein-Barr virus infection]. 20.) Infantile papular acrodermatitis (Gianotti's disease) and intrafamilial occurence of acute hepatitis B with jaundice: age dependency of clinical manifestations of hepatitis B virus infection. 21.) Immune response to hepatitis B virus in children with papular acrodermatitis. 22.) An epidemic of infantile papular acrodermatitis (Gianotti's disease) in Japan associated with hepatitis-B surface antigen subtype ayw. 23.) [Entity of the Gianotti-Crosti's syndrome and its relation to hepatitis B infection]. 24.) [Gianotti-Crosti syndrome in Epstein-Barr virus infection] 25.) Gianotti-Crosti syndrome associated with Epstein-Barr virus infection. 26.) Gianotti-Crosti syndrome associated with cytomegalovirus infection: report of one case. 27.) Gianotti-Crosti syndrome and human immunodeficiency virus infection [see comments]. 28.) An epidemic of infantile papular acrodermatitis (Gianotti-Crosti syndrome) due to Epstein-Barr virus. 29.) Papular acrodermatitis of childhood (Gianotti-Crosti disease). 30.) Gianotti-Crosti syndrome associated with Epstein-Barr virus infection. 31.) Gianotti-Crosti syndrome associated with hepatitis B surface antigen (subtype adr). 32.) Gianotti-Crosti syndrome. Non-parenterally acquired hepatitis B with a distinctive exanthem. 33.) Gianotti-Crosti syndrome: a retrospective analysis of 308 cases. 34.) Gianotti-Crosti syndrome. A review of ten cases not associated with hepatitis B. 35.) Infantile papular acrodermatitis (Gianotti's disease) and intrafamilial occurence of acute hepatitis B with jaundice: age dependency of clinical manifestations of hepatitis B virus infection. 36.) The Gianotti-Crosti syndrome. 37.) An epidemic of infantile papular acrodermatitis (Gianotti's disease) in Japan associated with hepatitis-B surface antigen subtype ayw. 38.) [Entity of the Gianotti-Crosti's syndrome and its relation to hepatitis B infection] 39.) Papulovesicular acrolocalized syndrome. 40.) Gianotti-Crosti syndrome related to rotavirus infection. 41.) [Syndrome of Gianotti-Crosti associated with hepatitis caused by Coxsackie B4 virus]. ================================================================ ===================================================================== 1.) Rilievi di una particolare casistica tossinfectiva caratterizzata de eruzione eritemato-infiltrativa desquamativa a focolai lenticolari. a sede electiva acroesposta. G. Ital Dermatol 1955;96:678-97 Gianotti F. ==================================================================== 2.) Dermatosis infantile erutiva acroesposta di probable origine virosica. Minerva Dermatol 1956;3(suppl):483-6 Crosti A. Gianotti F. ==================================================================== 3.) Gianotti-Crosti syndrome. SOURCE: Br J Dermatol (England), May 1968, 80(5) p342-3 AUTHOR(S): Gianotti F ==================================================================== 4.) Acrodermatitis of chilhood and other papovesicular acro-located Syndromes. Br J Dermatol 1979;100:49-59 Gianotti F. ==================================================================== ==================================================================== 5.) On infantile papular acrodermatitis (Gianotti disease) and infantile papular-similvesicular acrodermatitis (Gianotti syndrome). SO - J Dermatol 1975 Mar;2(1):5-14 AUTHOR(S): Endo M; Mori H; Morishima T PT - JOURNAL ARTICLE ==================================================================== ==================================================================== 6.) Infantile lichenoid acrodermatitis. Report of a case of Gianotti-Crosti syndrome. SO - Arch Dermatol 1965 Oct;92(4):398-401 AUTHOR(S): Endo M; Mori H; Morishima T PT - JOURNAL ARTICLE ==================================================================== ==================================================================== 7.)Detection of hepatitis B surface antigen subtype adr in an epidemic of papular acrodermatitis of childhood (Gianotti's disease). ==================================================================== Acta Med Okayama 1981 Dec;35(6):407-10 Kanzaki S, Kanda S, Terada K, Nohno S, Kumano K, Narahara K, Hayashi H, Kimoto H Papular acrodermatitis of childhood (PAC) has recently been reported to be associated with hepatitis B surface antigen (HBsAg) subtype ayw. Between September, 1978, and June, 1979, we saw 14 patients with PAC in a small epidemic occurring in Iwakuni City, Japan. HBsAg was detected in sera from all patients. Subtyping of HBsAg in 11 patients showed that 8 had a determinant adr and 3 had no detectable determinant because of low antigen titers. The result suggests that factors other than the specific HBsAg subtype contribute to the development of PAC. ==================================================================== 8.) Gianotti-Crosti syndrome: clinical, serologic, and therapeutic data from nine children. ==================================================================== Cutis 1998 Dec;62(6):271-4; quiz 286 Boeck K, Mempel M, Schmidt T, Abeck D Department of Dermatology and Allergy Biederstein, Technical University Munich, Germany. Gianotti-Crosti syndrome (GCS), a self-limiting papulovesicular acrodermatitis often associated with underlying viral infection, is mainly described in children. Nine children with GCS were evaluated with dermatologic examination and serologic tests for viral infections. Therapy was modified according to the subjective symptoms of patients, which included characteristic acrolocated papulovesicles, generalized skin eruption, and mild to severe pruritus. Results of serologic investigations revealed Epstein-Barr virus, Coxsackie A virus, parvovirus B19, and parainfluenza virus 1/2. In three children no underlying viral infection was found. Therapeutic interventions included topical clioquinol lotion 1 percent, topical application of corticosteroids, systemic antihistaminic therapy, and systemic methylprednisolone. Skin lesions resolved after 2 to 4 weeks in treated as well as in nontreated children. Although GCS in children often lacks close association with a causative viral infection, such severe infections as hepatitis B and human immunodeficiency virus must be considered. Whole-body involvement seems to correlate with severe pruritus and additional general symptoms requiring more intensive therapy. ==================================================================== 9.) [Adult papular acrodermatitis (Gianotti's disease). Report of 3 cases] ==================================================================== TT - [Acrodermatite papuleuse de l'adulte. A propos de 3 cas] SO - Ann Dermatol Venereol 1977 Mar;104(3):190-4 AUTHOR(S): Claudy AL; Ortonne JP; Trepo C; Bugnon B MC - English Abstract PT - JOURNAL ARTICLE AB - The authors report three cases of adult papular acrodermatitis with circulating HBs antigen. The eruption was followed by a benign icteric hepatitis which lasted from 30 to 45 days. In two cases, HBs antigen disappeared in a one month period, in one case the antigen has been present for more than three months. Direct immunofluorescence staining exhibits c3 deposits in the vessels of the dermal lesions, without any deposition of immunoglobulins or fibrinogen. We were unable to demonstrate the presence of HBs and " e " antigens in the skin lesions (using FITC conjugated specific antiserums). Serum protein concentrations of complement components C1q, C4,C3, C3PA were normal as measured by radial immunodiffusion. The percentage of circulating B and T cells was normal, as essayed by E-RFC, EAC-RFC and sIg. Thus, adult papular acrodermatitis, as well as the infantile form, does represent a sign of invasion of a benign viral hepatitis. ==================================================================== 10.) A 24 cases of human parvovirus B19 infection in children]. ==================================================================== Ann Pediatr (Paris) 1992 Nov;39(9):543-9 [Article in French] Borreda D, Palomera S, Gilbert B, Lienhardt A, de Lumley L Services de Pediatrie I, CHU Dupuytren, Limoges. From January 1, 1987 through December 31, 1990, twenty-four pediatric patients with human parvovirus B19 (HPV B19) infection were seen. In every case the diagnosis was established by a positive capture immunoassay for IgM antibodies against the HPV B19. Four patients had hematologic manifestations, including one case of transient bone marrow aplasia revealing hereditary spherocytosis, one case of autoimmune hemolytic anemia with beta-thalassemia, and two cases of peripheral thrombocytopenia. Eight patients had skin lesions, with a morbilliform rash in six cases, erythema nodosum in one case, and Gianotti-Crosti syndrome in one case. No patients had erythema infectiosum. Seven patients developed joint manifestations: Henoch-Schonlein purpura in two cases, arthralgia in four cases, and polyarticular disease progressing to severe rheumatoid arthritis in a thirteen-year-old girl. Unremarkable symptoms of viral disease were seen in three patients. A five-month-old infant developed severe acute myocarditis. One patient with hepatitis A had acute liver failure. This study confirms the broad spectrum of clinical manifestations of HPV B19 infection. There were a number of unusual findings, including the high rate of joint manifestations (29%) and the severe course of some hematologic and myocardial manifestations. These results raise the question of whether the HPV B19 may be involved in the genesis of chronic juvenile arthritis. ==================================================================== 11.) [An association between hepatitis-B antigen-negative infantile papular acrodermatitis and Epstein-Barr virus infection]. ==================================================================== [Article in Japanese] Hokkaido Igaku Zasshi 1989 Mar;64(2):125-38 Konno M Department of Pediatrics, Hokkaido University School of Medicine. The virological studies on 23 patients with infantile papular acrodermatitis (IPA) without hepatitis B virus (HBV)-associated antigens and antibodies were performed. The following results were obtained; 1) There was serological evidence of primary Epstein-Barr virus (EBV) infection in 17 out of 23 cases (74%). 2) The regression assays was done in 5 cases of IPA and 10 cases of infectious mononucleosis known to be associated with primary EBV infection in order to investigate the development of EBV-specific killer T cell activity in the primary EBV infection. The results confirm the evidence for EBV-specific cellular immunity in both patients with IPA and infectious mononucleosis. 3) The in vitro transformation assays was also done in 4 cases of IPA and 10 cases of infectious mononucleosis. Incidence of in vitro spontaneous transformation in the presence of cyclosporin A was significantly higher in patients of IPA and infectious mononucleosis than in the EBV seropositive controls. These results confirm that EBV plays an important role on the pathogenesis of HBV-negative IPA. ==================================================================== 12.) Gianotti-Crosti syndrome associated with infections other than hepatitis B. ==================================================================== JAMA 1986 Nov 7;256(17):2386-8 Draelos ZK, Hansen RC, James WD Although the Gianotti-Crosti syndrome (GCS) is regularly associated with hepatitis B infection elsewhere, in North America that association is rarely made. Accordingly, we studied nine children with acral, symmetrical eruptions typical of GCS for evidence of other infections. All were negative for hepatitis B surface antigen. Viral cultures were done in nine patients, and viruses isolated in two. One patient with a respiratory prodrome had respiratory syncytial virus (RSV) isolated, and a second patient studied simultaneously showed serological evidence of RSV infection. A third patient with both respiratory tract and gastrointestinal tract symptoms yielded a polio-vaccine enterovirus. Two patients with fever and pharyngitis had group A beta-hemolytic streptococci isolated from the throat. Skin biopsies were done in three cases, and findings were consistent with GCS. Electron microscopy of two lesional biopsy specimens failed to demonstrate viral particles. Epstein-Barr virus serological findings were negative in six cases and showed evidence of past infection in three cases. This study strengthens the observation that hepatitis B is not the causative agent of GCS in this country and suggests that multiple infectious agents may be associated with this distinctive exanthem. ==================================================================== 13.) [Infantile acro-localized papulovesicular syndrome]. ==================================================================== Dtsch Med Wochenschr 1986 Sep 26;111(39):1482-4 [Article in German] Schmidt KU, Hoting E, Mensing H, Nasemann T Papular acrodermatitis (Gianotti-Crosti syndrome) was seen in a six-year-old girl. The disease was marked by the characteristic triad of a papular-vesicular rash, lymphadenopathy and liver damage. Serological findings suggest an infection with Epstein-Barr virus as the causative factor. In such cases hepatitis-B induced papular eruptive acrodermatitis should be considered in differential diagnosis. ==================================================================== 14.) Gianotti-Crosti syndrome: a study of 26 cases. ==================================================================== Br J Dermatol 1986 Jul;115(1):49-59 Taieb A, Plantin P, Du Pasquier P, Guillet G, Maleville J We have studied 26 patients presenting with a symmetrical papular or papulovesicular acrolocated eruption of more than 10 days duration. Mean age at onset was 2 years (range 10 months to 5.75 years). Lymphadenopathy was noted in eight cases, and hepatomegaly in one case. In 12 cases, histopathology and direct immunofluorescence were non-contributory. Cytolytic hepatitis occurred in one case and was associated with HBs antigenemia. A history of recent immunization was given in two cases. There was serological evidence of recent Epstein-Barr virus infection in seven out of 13 cases tested. Coxsackie B viruses were isolated from three patients, and cytomegalovirus was probably associated with the syndrome in one case. We conclude that the Gianotti-Crosti syndrome is not rare in France, and that non-hepatitis B virus (HBV)-associated cases are more frequent than the classical HBV-associated papular acrodermatitis of childhood. ==================================================================== 15.) Papular acrodermatitis of childhood associated with hepatitis A virus infection. ==================================================================== Pediatr Dermatol 1985 Nov;3(1):31-3 Sagi EF, Linder N, Shouval D A 2-year-old girl developed an erythematous papular eruption on her face and extremities a week after an epidemic of hepatitis A had occurred in her school. Clinical and laboratory signs of acute hepatitis, together with serologic verification, confirmed hepatitis A infection. That diagnosis should be considered in the etiology of papular acrodermatitis of childhood. ==================================================================== 16.) [Gianotti-Crosti syndrome. HBsAG-negative papular acrodermatitis, an infantile papulovesicular acrolocalized syndrome]. ==================================================================== Monatsschr Kinderheilkd 1985 Feb;133(2):111-3 Article in German Ehringhaus C, Happle R, Dominick HC, Brune KH We report three cases of the Gianotti-Crosti syndrome (papulovesicular-acro-located syndrome of childhood), a self-limited common disease of childhood, which may be caused by various viral infections. The hepatitis B virus, however, is excluded by definition as a causal agent. The syndrome is characterized by itching papulo-vesicular skin lesions measuring 1-5 mm in diameter and localized to the limbs and face. The clinical and terminological differences between the HBsAG negative Gianotti-Crosti syndrome and the HBsAG positive Gianotti disease are emphasized. ==================================================================== 17.) [Pediatric papular acrodermatitis and double primary infection by the hepatitis B virus and the Epstein-Barr virus]. ==================================================================== Ann Dermatol Venereol 1985;112(11):889-92 [Article in French] Taieb A, Pompougnac E, Hans P, Fontan I, Maleville J A case of papular infantile acrodermatitis was evaluated in a twenty-two month-old child. Laboratory data showed the presence of a cytolytic hepatitis associated to an increase in circulating monocytes (1.500/mm3) with hyperbasophilic cells. Hepatitis B surface (HBs) antigen was detected in the serum, associated to anti-HBc antibodies of the IgM class, without detectable anti-HBs antibodies. Simultaneously, EBV serologic profiles were consistent with a primary infection. The authors review the clinical presentation of previously described cases according to their suspected cause, and discuss the etiologic role of both EBV and HBV in the hereby reported case. ==================================================================== 18.) Gianotti-Crosti syndrome. A review of ten cases not associated with hepatitis B. ==================================================================== Arch Dermatol 1984 Jul;120(7):891-6 Spear KL, Winkelmann RK Studies of data from ten cases of infantile acrodermatitis and from eight cases reported in the North American literature disclose distinctive papular dermatosis of the face and extremities, often related to virus infection. None of our eight patients who were tested had evidence of hepatitis B infections, although transaminase values were elevated in two. All five patients who were tested had lymphocytosis. Six patients had antecedent upper respiratory tract symptoms. Data from our cases and from the other previously reported cases indicate that the eruption is a virus-related response. Although the hepatitis virus has been the most frequently encountered causative agent to date, other viruses, including Epstein-Barr virus, coxsackievirus, and parainfluenza virus, may produce a similar cutaneous response. ==================================================================== 19.) [Acrodermatitis papulosa eruptiva infantum and Epstein-Barr virus infection]. ==================================================================== Hautarzt 1984 Feb;35(2):97-9 [Article in German] Gengoux P, Vincke P, Tennstedt D, Lachapelle JM A typical Gianotti-Crosti syndrome was observed in an 18-month-old boy. This infantile papular acrodermatitis was associated with Epstein-Barr virus but also with B-antigen-negative hepatitis. Biological and serological parameters have been followed up during the course of the illness. ==================================================================== 20.) Infantile papular acrodermatitis (Gianotti's disease) and intrafamilial occurence of acute hepatitis B with jaundice: age dependency of clinical manifestations of hepatitis B virus infection. ==================================================================== J Infect Dis 1978 Aug;138(2):211-6 Toda G, Ishimaru Y, Mayumi M, Oda T Infantile papular acrodermatitis (IPA, Gianotti's disease) is a clinical manifestation of hepatitis B virus (HBV) infection in childhood. An epidemic of of IPA occurred in Matsuyama, Japan, where 153 patients in a pediatric clinic had IPA between October 1974 and March 1977. In this period 12 mothers and two fathers of patients contracted acute hepatitis B with overt jaundice three to 14 months after their offspring had IPA. Analysis of the subtype of hepatitis B surface antigen (HBsAg) in the infants and their jaundiced mothers and/or fathers disclosed that HBV was transmitted from the infants. All of the index cases were one year old or younger, although the age of patients with IPA ranged from three months to 10 years. In approximately 40% of patients with IPA who were one year old or younger, HBs antigenemia persisted for one year. These facts suggested that the contraction of IPA in children, especially those one year old or younger, was an important route toward establishment of the carrier state of HBV which maintains the reservoir of this virus in the community. ==================================================================== 21.) Immune response to hepatitis B virus in children with papular acrodermatitis. ==================================================================== Gastroenterology 1977 Nov;73(5):1103-6 Colombo M, Gerber MA, Vernace SJ, Gianotti F, Paronetto F Papular acrodermatitis of childhood (PAC) is characterized by papular eruption of skin, lymphadenopathy, and acute hepatitis B surface antigen (HBsAg)-positive anicteric hepatitis. To study the course of hepatitis B virus infection we followed 16 patients with PAC, 2 to 7 years of age, for periods ranging from 6 to 46 months. All patients tested developed hepatitis B surface antigenemia subtype ay, and produced antibody to hepatitis B core antigen with the highest incidence after 3 to 5 months. Half of the children investigated developed antibody to hepatitis B surface antigen 4 to 18 months (mean, 6.5) after the onset of PAC. At the end of the investigation, 31% of the children were still HBsAg-positive, 50% were antibody to hepatitis B core antigen-positive, and in 43% the activity of serum aminotransferases was abnormal. Liver biopsy repeated in 2 children showed chronic aggressive hepatitis. The pattern of antibody response to hepatitis B virus is similar in both HBsAg-positive hepatitis and PAC. The frequent development of HBSAg carrier state and the high proportion of children with liver abnormalities at the end of the investigation suggest an impaired clearance of hepatitis B virus and a tendency to chronicity. ==================================================================== 22.) An epidemic of infantile papular acrodermatitis (Gianotti's disease) in Japan associated with hepatitis-B surface antigen subtype ayw. ==================================================================== Lancet 1976 Apr 3;1(7962):707-9 Ishimaru Y, Ishimaru H, Toda G, Baba K, Mayumi M An epidemic of infantile papular acrodermatitis (I.P.A.) (Gianotti's disease) occurred in Matsuyama City, in south-east Japan in 1974-75. Patients ages ranged from less than one year to eight years. Hepatitis-B surface antigen (HBsAg) was detected by an immune adherence haemagglutination method in the serum samples of 48 of the 54 patients tested. HBsAg subtypes were determined by a haemagglutination-inhibition method. ayw antigens were identified in 42 patients and adr antigens in 3; it was not possible to determine subtypes in the remaining 3 patients because antigen titres were too low. Since subtype ayw and I.P.A. are extremely rare in Japan, the association of the disease with HBsAg subtype ayw is regarded as being most significant. ==================================================================== 23.) [Entity of the Gianotti-Crosti's syndrome and its relation to hepatitis B infection]. ==================================================================== Hautarzt 1975 Sep;26(9):471-9 [Article in German] Milbradt R, Nasemann T 6 cases of acrodermatitis papulosa eruptiva infantum (acrodermatitis papulosa infantilis or Gianotti-Crostisyndrome: G.C.S.) were observed and the clinical features of this disease are discussed. 1. An erythemato-papular dermatitis mainly of the face, legs, arms, buttocks, not itching, without re-occurrence lasting on the average 20--25 days. 2. An distinct enlargement of the lymph nodes, especially of the inguinal and axillary areas (reactive reticulo-histocytic lymphadenitis). 3. Acute hepatitis, mostly without icterus. 4. Presence of HB Ag-Australia Antigen in the serum of patients a few days after the onset of the disease. Doubts concerning the entity of G.C.S. are getting irrelevant considering the distinct characteristics. The viral genesis already suggested by Gianotti and Crosti of the picture of the disease seems to be true: in all cases Australian antigens are positive. The infectiousness, but the small danger of infection, even if the disease dates back a few months, should not be underestimated. When diagnosing G.C.S. among others the akrolocalized papular-vesicular syndrome described by Crosti and Gianotti should be considered. In 2 patients we could find by electron microscopic studies microtubular aggregates having a diameter of 200 A. These aggregates were situated in the cytoplasm of endothelial cells of smaller vessels in the upper part of the corium. ==================================================================== 24.) [Gianotti-Crosti syndrome in Epstein-Barr virus infection] ==================================================================== TO: Gianotti-Crosti-Syndrom bei Epstein-Barr-Virus-Infektion. AU: Schopf-RE AD: Universitats-Hautklinik, Mainz. SO: Hautarzt. 1995 Oct; 46(10): 714-6 ISSN: 0017-8470 PY: 1995 LA: GERMAN; NON-ENGLISH CP: GERMANY AB: Gianotti-Crosti syndrome, a relatively rare, distinctive eruption occurring after hepatitis B infection, is characterized by a lichenoid papular exanthema, usually localized on the face, limbs, and buttocks. Hepatitis B antigenaemia is associated with Gianotti-Crosti syndrome only in some cases. Recent reports indicate that a variety of infectious agents are associated with Gianotti-Crosti syndrome. This is a report of 2 1/2-year-old girl with Gianotti-Crosti syndrome and concurrent primary Epstein-Barr virus infection without evidence of hepatitis B infection. ==================================================================== 25.) Gianotti-Crosti syndrome associated with Epstein-Barr virus infection. ==================================================================== Hofmann B; Schuppe HC; Adams O; Lenard HG; Lehmann P; Ruzicka T Department of Dermatology, Heinrich Heine University, Dusseldorf, Germany. Pediatr Dermatol (UNITED STATES) Jul-Aug 1997 14 (4) p273-7 ISSN: 0736-8046 Language: ENGLISH Document Type: JOURNAL ARTICLE Journal Announcement: 9711 Subfile: INDEX MEDICUS Gianotti-Crosti syndrome (GCS) is a distinct exanthematic, acrolocated eruption of childhood caused by a variety of infectious agents. Historically hepatitis B antigen positive (HBsAG+) papular acrodermatitis of childhood and HBsAg negative (HBsAg-) papulovesicular acrolocated syndrome have been distinguished. Here we characterize the spectrum of associated infectious agents in seven patients with confirmed GCS seen in our departments in the years 1994-1995. Where available, stored frozen serum samples were reanalyzed for antiviral antibodies. The mean age of the two girls and five boys was 22.5 months with a range of 8 to 53 months. None of the patients was HBsAG+. Four patients showed serologic evidence of an acute infection and one patient of a recent Epstein-Barr virus (EBV) infection. In two additional children vaccination preceded the appearance of GCS. In these two patients serologic investigations revealed no evidence of recent infection with most common viruses. Our results underline the role of viral infections other than hepatitis B in the etiology of GCS. EBV infection was the most commonly associated viral disease in our population. We agree with other authors that we should avoid using the terms papular acrodermatitis of childhood and papulovesicular acrolocated syndrome in describing ==================================================================== 26.) Gianotti-Crosti syndrome associated with cytomegalovirus infection: report of one case. ==================================================================== Au: Tzeng GH; Hsu CY; Chen HC. Ad: Department of Pediatrics, Taipei Municipal Women's and Children's General Hospital, Taiwan, R.O.C. So: Acta Paediatr Sin; 36(2):139-41, 1995 Mar-Apr. Ab: A one and half a month-old infant, a female, was brought to this hospital with the chief problem of diarrhea lasting for more than one week. Four days after admission, symmetric and nonpruritic lichenoid papules developed over her face and limbs. Physical examination showed several small palpable lymph nodes over the bilateral inguinal areas, but without hepatosplenomegaly. Gianotti-Crosti syndrome was diagnosed. Latter on, cytomegalovirus (CMV) was isolated from urine and throat swab. It seemed that this case of Gianotti-Crosti syndrome was associated with CMV infection (Au). ==================================================================== 27.) Gianotti-Crosti syndrome and human immunodeficiency virus infection [see comments]. ==================================================================== Au: Blauvelt A; Turner ML. Ad: Dermatology Branch, National Cancer Institute, Bethesda, Md. Cm: Comment in:/Arch Dermatol/1995 Jan;131(1):108-9. So: Arch Dermatol; 130(4):481-3, 1994 Apr. Ab: BACKGROUND: Patients with Gianotti-Crosti syndrome (GCS) present with a distinctive self-limiting acral papular or papulovesicular eruption associated with an underlying viral illness. Gianotti-Crosti syndrome in patients infected with human immunodeficiency virus has not been previously reported. OBSERVATIONS: We report on two children infected with human immunodeficiency virus who had GCS. Both patients had clinical and histopathologic findings characteristic of GCS. The first patient had evidence of prior infection with cytomegalovirus, without evidence of active viral illness. The second patient had evidence of subclinical infection with cytomegalovirus, positive hepatitis C antibody, and active infection with Mycobacterium avium-intracellulare at the time the skin eruption began. CONCLUSIONS: We call attention to a previously unreported skin eruption, GCS, in the setting of human immunodeficiency virus infection and emphasize that determining the etiologic factors for human immunodeficiency virus-associated GCS will be difficult; such patients will probably have a variety of clinical and subclinical infections that complicate this issue (Au). ==================================================================== 28.) An epidemic of infantile papular acrodermatitis (Gianotti-Crosti syndrome) due to Epstein-Barr virus. ==================================================================== SO - Dermatology 1994;188(3):203-4 AU - Baldari U; Monti A; Righini MG MT - Female; Human; Male PT - JOURNAL ARTICLE AB - Five out of twelve 13- to 15-month-old children, attending the same class of a creche in Forli (Italy), presented infantile papular acrodermatitis (Gianotti-Crosti syndrome), associated with lymphocytosis and evidence for a recent Epstein-Barr virus infection. This cluster may be due to two facts: (1) the long and close contacts among the patients and (2) the concurrent immunization with a combined diphtheria-tetanus-pertussis-poliomyelitis vaccine from 2 to 6 weeks previously. ==================================================================== 29.) Papular acrodermatitis of childhood (Gianotti-Crosti disease). ==================================================================== SO - Pediatr Dermatol 1991 Sep;8(3):224-7 AU - Magyarlaki M; Drobnitsch I; Schneider I MT - Case Report; Human; Male PT - JOURNAL ARTICLE AB - An 11-year-old boy had lentil-sized lichenoid papules, localized to the limbs and trunk, together with acute, nonicteric, hepatitis B surface antigen-positive hepatitis. The clinical picture and course were typical of Gianotti-Crosti disease. Monoclonal antibodies were used to study the lymphocyte subpopulations and surface antigens in the inflammatory infiltrate in frozen sections of a skin biopsy specimen. The results provide data on the pathogenic mechanism of the papular exanthem. ==================================================================== 30.) Gianotti-Crosti syndrome associated with Epstein-Barr virus infection. ==================================================================== SO - J Am Acad Dermatol 1989 Feb;20(2 Pt 2):336-8 AU - Lowe L; Hebert AA; Duvic M MT - Case Report; Female; Human PT - JOURNAL ARTICLE; REVIEW (15 references); REVIEW, TUTORIAL AB - Gianotti-Crosti syndrome, a distinctive eruption occurring after hepatitis B infection, is characterized by symmetric, nonpruritic lichenoid papules usually localized to the face, limbs, and buttocks. In North America, hepatitis B antigenemia is rarely associated with Gianotti-Crosti syndrome in infants. Recent reports indicate there are a variety of infectious agents associated with Gianotti-Crosti syndrome. We report a case of an 11-month-old white female infant with Gianotti-Crosti syndrome and concurrent primary Epstein-Barr virus infection without evidence of hepatitis B infection. ==================================================================== 31.) Gianotti-Crosti syndrome associated with hepatitis B surface antigen (subtype adr). ==================================================================== SO - J Am Acad Dermatol 1985 Apr;12(4):629-33 AU - Lee S; Kim KY; Hahn CS; Lee MG; Cho CK MT - Case Report; Human; Male PT - JOURNAL ARTICLE AB - The Gianotti-Crosti syndrome, papular acrodermatitis of childhood (PAC), is an infrequently recognized disorder with distinctive characteristics. At present hepatitis B virus is thought to be an etiologic agent. The disease is very rare in Korea, in spite of the high frequency of hepatitis B surface antigen (HBsAg) in the general population. It is known that subtype ayw of the HBsAg may influence the pathogenesis of PAC, but subtype analysis of HBsAg in these patients disclosed adr. Therefore, our studies reconfirmed that PAC may in addition be associated with subtype adr of HBsAg. We believe that the lower incidence of PAC in Korea as compared with the high incidence of PAC in other parts of the world, such as in the Mediterranean area, may be due to the fact that a higher predisposition to PAC is conferred by subtype ayw of HBsAg. ==================================================================== 32.) Gianotti-Crosti syndrome. Non-parenterally acquired hepatitis B with a distinctive exanthem. ==================================================================== SO - Med J Aust 1983 Feb 19;1(4):175-6 AU - Fergin P MT - Case Report; Human; Male PT - JOURNAL ARTICLE AB - A case of Gianotti-Crosti syndrome is reported. This condition is an uncommon form of non-parenterally acquired hepatitis B of children. The distinctive eruption of Gianotti-Crosti syndrome may be the only symptom or sign of associated-hepatitis B. Chronic hepatitis may develop in some patients. ==================================================================== 33.) Gianotti-Crosti syndrome: a retrospective analysis of 308 cases. ==================================================================== SO - J Am Acad Dermatol 1992 Feb;26(2 Pt 1):207-10 AU - Caputo R; Gelmetti C; Ermacora E; Gianni E; Silvestri A MT - Female; Human; Male PT - JOURNAL ARTICLE AB - BACKGROUND: There is no agreement as to whether papular acrodermatitis of childhood caused by hepatitis B virus can be differentiated from other papulovesicular acrolocated syndromes. OBJECTIVE: We attempted to establish whether such differentiation is possible comparing histories, signs, and symptoms of all patients who have been previously diagnosed as having papular acrodermatitis of childhood or papulovesicular acrolocated syndromes. METHODS: Files of 308 patients hospitalized in the past three decades were studied. Photographs were examined by a panel of experts to determine whether it was possible to distinguish between papular acrodermatitis of childhood and papulovesicular acrolocated syndromes solely on the basis of cutaneous signs. RESULTS: The retrospective analysis confirmed a significant overlapping of the two types of the disease. The blind survey of photographs of the patients revealed that a distinction between the forms was not clinically possible. CONCLUSION: Acrodermatitis is a self-limiting cutaneous response to different viruses; clinical differences are probably due to individual characteristics of each patient rather than the causative virus. ==================================================================== 34.) Gianotti-Crosti syndrome. A review of ten cases not associated with hepatitis B. ==================================================================== SO - Arch Dermatol 1984 Jul;120(7):891-6 AU - Spear KL; Winkelmann RK MT - Female; Human; Male PT - JOURNAL ARTICLE AB - Studies of data from ten cases of infantile acrodermatitis and from eight cases reported in the North American literature disclose distinctive papular dermatosis of the face and extremities, often related to virus infection. None of our eight patients who were tested had evidence of hepatitis B infections, although transaminase values were elevated in two. All five patients who were tested had lymphocytosis. Six patients had antecedent upper respiratory tract symptoms. Data from our cases and from the other previously reported cases indicate that the eruption is a virus-related response. Although the hepatitis virus has been the most frequently encountered causative agent to date, other viruses, including Epstein-Barr virus, coxsackievirus, and parainfluenza virus, may produce a similar cutaneous response. ==================================================================== 35.) Infantile papular acrodermatitis (Gianotti's disease) and intrafamilial occurence of acute hepatitis B with jaundice: age dependency of clinical manifestations of hepatitis B virus infection. ==================================================================== SO - J Infect Dis 1978 Aug;138(2):211-6 AUTHOR(S): Toda G; Ishimaru Y; Mayumi M; Oda T PT - JOURNAL ARTICLE AB - Infantile papular acrodermatitis (IPA, Gianotti's disease) is a clinical manifestation of hepatitis B virus (HBV) infection in childhood. An epidemic of of IPA occurred in Matsuyama, Japan, where 153 patients in a pediatric clinic had IPA between October 1974 and March 1977. In this period 12 mothers and two fathers of patients contracted acute hepatitis B with overt jaundice three to 14 months after their offspring had IPA. Analysis of the subtype of hepatitis B surface antigen (HBsAg) in the infants and their jaundiced mothers and/or fathers disclosed that HBV was transmitted from the infants. All of the index cases were one year old or younger, although the age of patients with IPA ranged from three months to 10 years. In approximately 40% of patients with IPA who were one year old or younger, HBs antigenemia persisted for one year. These facts suggested that the contraction of IPA in children, especially those one year old or younger, was an important route toward establishment of the carrier state of HBV which maintains the reservoir of this virus in the community. ==================================================================== 36.) The Gianotti-Crosti syndrome. ==================================================================== SO - Pediatrics 1978 Mar;61(3):433-7 AUTHOR(S): Rubenstein D; Esterly NB; Fretzin D PT - JOURNAL ARTICLE AB - The Gianotti-Crosti syndrome is an infrequently recognized disorder with distinctive characteristics. The eruption, which lasts for two to eight weeks, consists of large, flat-topped, nonpruritic papules on the face, buttocks, and limbs. Its onset may be preceded by fever and upper respiratory tract symptoms. Associated findings include generalized lymphadenopathy, anicteric hepatitis, and HBs antigenemia. Two children with the syndrome are described to bring this entity to the attention of pediatricians. ==================================================================== 37.) An epidemic of infantile papular acrodermatitis (Gianotti's disease) in Japan associated with hepatitis-B surface antigen subtype ayw. ==================================================================== SO - Lancet 1976 Apr 3;1(7962):707-9 AUTHOR(S): Ishimaru Y; Ishimaru H; Toda G; Baba K; Mayumi M PT - JOURNAL ARTICLE AB - An epidemic of infantile papular acrodermatitis (I.P.A.) (Gianotti's disease) occurred in Matsuyama City, in south-east Japan in 1974-75. Patients ages ranged from less than one year to eight years. Hepatitis-B surface antigen (HBsAg) was detected by an immune adherence haemagglutination method in the serum samples of 48 of the 54 patients tested. HBsAg subtypes were determined by a haemagglutination-inhibition method. ayw antigens were identified in 42 patients and adr antigens in 3; it was not possible to determine subtypes in the remaining 3 patients because antigen titres were too low. Since subtype ayw and I.P.A. are extremely rare in Japan, the association of the disease with HBsAg subtype ayw is regarded as being most significant. ==================================================================== 38.) [Entity of the Gianotti-Crosti's syndrome and its relation to hepatitis B infection] TT - [Uber die Entitat des Gianotti-Crosti-Syndroms und seine Beziehung zur Hepatitis-B-Infektion] ==================================================================== SO - Hautarzt 1975 Sep;26(9):471-9 AUTHOR(S): Milbradt R; Nasemann T MC - English Abstract PT - JOURNAL ARTICLE AB - 6 cases of acrodermatitis papulosa eruptiva infantum (acrodermatitis papulosa infantilis or Gianotti-Crostisyndrome: G.C.S.) were observed and the clinical features of this disease are discussed. 1. An erythemato-papular dermatitis mainly of the face, legs, arms, buttocks, not itching, without re-occurrence lasting on the average 20--25 days. 2. An distinct enlargement of the lymph nodes, especially of the inguinal and axillary areas (reactive reticulo-histocytic lymphadenitis). 3. Acute hepatitis, mostly without icterus. 4. Presence of HB Ag-Australia Antigen in the serum of patients a few days after the onset of the disease. Doubts concerning the entity of G.C.S. are getting irrelevant considering the distinct characteristics. The viral genesis already suggested by Gianotti and Crosti of the picture of the disease seems to be true: in all cases Australian antigens are positive. The infectiousness, but the small danger of infection, even if the disease dates back a few months, should not be underestimated. When diagnosing G.C.S. among others the akrolocalized papular-vesicular syndrome described by Crosti and Gianotti should be considered. In 2 patients we could find by electron microscopic studies microtubular aggregates having a diameter of 200 A. These aggregates were situated in the cytoplasm of endothelial cells of smaller vessels in the upper part of the corium. ==================================================================== 39.) Papulovesicular acrolocalized syndrome. ==================================================================== Cutis (United States), Apr 1985, 35(4) p362-3 AUTHOR(S): Paltzik RL; Aiello AM PUBLICATION TYPE: JOURNAL ARTICLE ABSTRACT: A 1-year-old boy with a cutaneous eruption compatible with papulovesicular acrolocalized syndrome is described. This unusual but benign entity of early childhood can be differentiated both by its clinical presentation and appropriate laboratory testing from the two morphologically similar eruptions: Gianotti-Crosti syndrome and infection with Coxsackie virus A-16. ==================================================================== 40.) Gianotti-Crosti syndrome related to rotavirus infection. Pediatr Dermatol 1998 Nov-Dec;15(6):485-6 Di Lernia V ==================================================================== ==================================================================== 41.) [Syndrome of Gianotti-Crosti associated with hepatitis caused by the Coxsackie B4 virus]. ==================================================================== Med Clin (Barc) 1992 Jun 27;99(5):195 [Article in Spanish] Ruiz de Erenchun F, Roman J, Villaizan C, Quintanilla E =================================================================== ================================================================= DATA-MÉDICOS/DERMAGIC-EXPRESS No (69) 08/09/99 DR. JOSÉ LAPENTA R. =================================================================== |
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Produced by Dr. José Lapenta R.
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