A 3 year-old patient presents with a papular rash on the arms and legs that largely spares the trunk. The patient recently had a cold, but has otherwise been well. What’s the diagnosis? What causes it? And how do we treat it?
Gianotti-Crosti syndrome (aka papular acrodermatitis) is an uncommon rash that predominantly affects young children. The cause is unknown, but thought to be an immune response to a recent systemic infection. The most common associations are EBV and HBV, but can occur following a number of infections (e.g., coxsackie, RSV, parvovirus, parainfluenza, bartonella, mycoplasma, GAS, etc.)
The rash is papular (often coalescing into plaques over time), skin-colored or erythematous, and predominantly affects the extremities. Lesions may be itchy. The rash is self-limited and treatment is supportive.