Gianotti‐Crosti Syndrome Associated with Epstein‐Barr Virus Infection

Abstract

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 HBsAg+ and HBsAg- forms of GCS.

Síndrome de Gianotti-Crosti: aspectos clínicos, laboratoriais e perfis sorológicos observados em 10 casos procedentes de Belém-PA (Brasil)

“…Pesquisa de Gianotti (Table 1). [2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18] In the literature consulted, there were only two references 5,7 to HHV6 as a cause of the disease.…”

“…3,4,6,7,10,[14][15][16] The cutaneous lesions are generally asymptomatic, but exceptionally pruriginous. 4,7,8,10,13,14,16 Viruses HBV , 2-4, 6-16, 18 HCV, 4,9,14 HAV, 4, 8-10, 13, 14 EBV, 3, 4, 6-11 ,13-17 CMV, 3,4,[7][8][9][10][11][13][14][15][16]5,7 Coxsackie virus A-16, B-4 and B-5, 3, 4, 7-11, 13-15, 17 adenovirus, 9,14 respiratory syncytial virus, 4,[7][8][9][10][11][13][14][15] parainfluenza virus, 3, 4, 7, 9-11, 13-15 parvovirus B-19, 7, 9-11, 14 rotavirus, 9,14 Bacteria Group A b-hemolytic streptococci, …”

“…Posteriormente foram observadas erupções cutâneas idênti-cas à da SGC, mas sem evidência de infecção aguda pelo vírus da hepatite B. Durante a investigação etiológica dos casos aqui apresentados, verificou-se que eram decorrentes de diferentes agentes infecciosos, principalmente virais (Tabela 1). [2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18] Na literatura consultada, há apenas duas referências 5,7 ao HHV6 como causador da doença. O curso da SGC é benigno e autolimitado, desaparecendo as manifestações em prazo que varia de duas a oito semanas, sem recorrências.…”

“…Uma linfocitose, eventualmente com presença de linfócitos atípicos no sangue periférico, pode ainda ser observada. 3,[7][8][9][10][13][14][15] …”

Gianotti-Crosti Syndrome Following Japanese Encephalitis Vaccination

“…This syndrome is frequently associated with hepatitis B (HB) antigenemia (2), but hepatitis B virus (HBV) antigen-negative cases had been subsequently described by Gianotti (2). A wide spectrum of viral diseases and preceding immunizations are associated with the disease (3,4).…”