By vgreene, 27 March, 2018
By vgreene, 27 March, 2018
By vgreene, 27 March, 2018
By vgreene, 27 March, 2018
By vgreene, 27 March, 2018
By vgreene, 27 March, 2018
By vgreene, 27 March, 2018
By vgreene, 27 March, 2018
(BMJ)—A 2-yo boy presented w/ a 10-day hx of a nonpruritic, red, papular rash on his knees, elbows, buttocks, and face. He had a recent URI but was clinically well. What is the dx?
Scabies
Erythema multiforme
Keratosis pilaris
Gianotti-Crosti syndrome
Urticaria pigmentosa
You are correct. Gianotti-Crosti syndrome, also known as “infantile papular acrodermatitis,” is associated w/ several viral infections, including Epstein-Barr virus, adenovirus, herpesvirus 6, CMV, enterovirus, and, rarely, hepatitis B. It is a clinical dx that most commonly affects children 1-6 yo but can be seen up to age 12, and occasionally in adults. Prodromal sx are often nonspecific and include malaise, low-grade fever, rhinitis, and diarrhea. The rash is typically erythematous, papulovesicular, and nonpurpuric, and is symmetrically distributed over the buttocks, face, and extensor surfaces of the knees and elbows. Koebner phenomenon can arise in the early stage, and there might be associated generalized lymphadenopathy. Pts and families should be reassured that Gianotti-Crosti syndrome is a self-limiting condition. Emollients can provide symptomatic relief, in addition to topical steroids if the rash is pruritic.

BMJ 2018;360:j5547