A Case of Recurrent vaccine-triggered Gianotti–Crosti Syndrome

Abstract

Gianotti–Crosti syndrome (GCS) is a self-limited benign dermatosis, clinically characterized by a monomorphic papular or papulovesicular eruption symmetrically distributed on the limbs and face of children. Various viral and vaccine triggers have been associated with GCS. Recurrences are uncommon but have been reported. We report a case of recurrent vaccine-triggered GCS.

Gianotti-Crosti syndrome: exanthema following a vaccination

“…Assaf et al reported a recurrence case following 2 different types of vaccination: vaccinated with hepatitis B and 3 months later having recurrence after receiving MMR vaccine. 5 On the other hand, two cases were reports that administration of a single episode MMR vaccine does not associate with GCS cases recurrence. 5,9 Education to the parents about GCS is important to prevent unnecessary tests and treatment also vaccination avoidance later.…”

“…1,[8][9][10] Vaccines associated with GCS are as following Haemophilus influenza type b (Hib); oral polio; diphtheria, pertussis, and tetanus (DPT); measles, mumps, and rubella (MMR); bacillus Calmette-Guerin (BCG); hepatitis B and A, and Japanese encephalitis. 1,5,9,11 It was reported in the literature that 21 out of 300 GCS cases were associated with vaccination. 9 There are two main hypotheses of GCS pathogenesis.…”

“…Second, the delayed hypersensitivity reaction (type 4 hypersensitivity reaction) in the dermis layer as a response to infections (virus or bacteria) and vaccines. 1,4,5 Another study by Caltabiano et al reported that discover increasing human beta-defensin-4 (hBD-4) activity in the epidermis, indicating viral antigenemia probably has a role in pathogenesis of GCS. 12 On general examination, the child usually appears healthy.…”

“…Our patient responded well to moderate potency of topical corticosteroid, emollients, and antihistamines within 2 weeks on treatment. 1,2,5,9 The prognosis of GCS is generally good, recurrence is unusual. There were 3 relapse cases have been reported in the literature.…”

“…1,4 In general, the incidence of GCS is unknown although many GCS cases are believed to be underdiagnosed as viral rash or nonspecific viral exanthema. 5,6 Nonetheless, many countries such as Great Britain, France, Germany, Spain, Russia, Turkey, Hong Kong, China, Japan, India, and Singapore have been reported GCS cases. [7][8] We reported a GCS case in a 9-month-old baby following a vaccination.…”