REFERENCIAS BIBLIOGRÁFICAS / BIBLIOGRAPHICAL REFERENCES

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A.- Gianotti-Crosti Syndrome Mimicking Scabies (2024).

B.-Gianotti-Crosti Syndrome and Allergic Background (2003).

C.- Gianotti-Crosti Syndrome as Presenting Sign of Cytomegalovirus Infection: A Case Report and a Critical Appraisal of Its Possible Cytomegalovirus Etiology (2016).

D.- Gianotti-Crosti Syndrome Associated With Epstein-Barr Virus Infection (1997).

E. Gianotti-Crosti Syndrome: A Retrospective Analysis of 308 Cases (1992).

F.- Gianotti-Crosti Syndrome-Like Reaction to Molluscum Contagiosum-Clinical Characteristics and Response to Treatment (2021).

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1.) Rilievi di una particolare casistica tossinfettiva 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]. 

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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. 

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2.) Dermatosis infantile erutiva acroesposta di probable origine virosica. 

Minerva Dermatol 1956;3(suppl):483-6 

Crosti A. Gianotti F. 

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3.) Gianotti-Crosti syndrome. 

SOURCE: Br J Dermatol (England), May 1968, 80(5) p342-3 

AUTHOR(S): Gianotti F 

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4.) Acrodermatitis of chilhood and other papovesicular acro-located Syndromes. 

Br J Dermatol 1979;100:49-59 

Gianotti F. 

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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 

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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 

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7.)Detection of hepatitis B surface antigen subtype adr in an epidemic of papular acrodermatitis of childhood (Gianotti's disease). 

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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. 

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8.) Gianotti-Crosti syndrome: clinical, serologic, and therapeutic data  from nine children. 

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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. 

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9.) [Adult papular acrodermatitis (Gianotti's disease). Report of 3 cases] 

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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. 

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10.) A 24 cases of human parvovirus B19 infection in children]. 

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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. 

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11.) [An association between hepatitis-B antigen-negative infantile papular  acrodermatitis and Epstein-Barr virus infection]. 

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[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. 

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12.) Gianotti-Crosti syndrome associated with infections other than  hepatitis B. 

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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. 

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13.) [Infantile acro-localized papulovesicular syndrome]. 

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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. 

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14.) Gianotti-Crosti syndrome: a study of 26 cases. 

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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. 

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15.) Papular acrodermatitis of childhood associated with hepatitis A virus  infection. 

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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. 

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16.) [Gianotti-Crosti syndrome. HBsAG-negative papular acrodermatitis, an  infantile papulovesicular acrolocalized syndrome]. 

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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. 

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17.) [Pediatric papular acrodermatitis and double primary infection by the  hepatitis B virus and the Epstein-Barr virus]. 

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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. 

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18.) Gianotti-Crosti syndrome. A review of ten cases not associated with  hepatitis B. 

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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. 

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19.) [Acrodermatitis papulosa eruptiva infantum and Epstein-Barr virus  infection]. 

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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. 

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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. 

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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. 

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21.) Immune response to hepatitis B virus in children with papular  acrodermatitis. 

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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. 

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22.) An epidemic of infantile papular acrodermatitis (Gianotti's disease)  in Japan associated with hepatitis-B surface antigen subtype ayw. 

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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. 

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23.) [Entity of the Gianotti-Crosti's syndrome and its relation to  hepatitis B infection]. 

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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. 

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24.) [Gianotti-Crosti syndrome in Epstein-Barr virus infection] 

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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. 

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25.) Gianotti-Crosti syndrome associated with Epstein-Barr virus infection. 

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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 

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26.) Gianotti-Crosti syndrome associated with cytomegalovirus  infection: report of one case. 

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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). 

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27.) Gianotti-Crosti syndrome and human immunodeficiency virus infection  [see comments]. 

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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). 

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28.) An epidemic of infantile papular acrodermatitis (Gianotti-Crosti  syndrome) due to Epstein-Barr virus. 

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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. 

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29.) Papular acrodermatitis of childhood (Gianotti-Crosti disease). 

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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. 

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30.) Gianotti-Crosti syndrome associated with Epstein-Barr virus infection. 

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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. 

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31.) Gianotti-Crosti syndrome associated with hepatitis B surface antigen  (subtype adr). 

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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. 

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32.) Gianotti-Crosti syndrome. Non-parenterally acquired hepatitis B with a  distinctive exanthem. 

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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. 

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33.) Gianotti-Crosti syndrome: a retrospective analysis of 308 cases. 

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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. 

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34.) Gianotti-Crosti syndrome. A review of ten cases not associated with  hepatitis B. 

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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. 

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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. 

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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. 

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36.) The Gianotti-Crosti syndrome. 

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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. 

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37.) An epidemic of infantile papular acrodermatitis (Gianotti's disease)  in Japan associated with hepatitis-B surface antigen subtype ayw. 

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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. 

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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] 

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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. 

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39.) Papulovesicular acrolocalized syndrome. 

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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. 

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40.) Gianotti-Crosti syndrome related to rotavirus infection.  Pediatr Dermatol 1998 Nov-Dec;15(6):485-6  Di Lernia V 

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41.) [Syndrome of Gianotti-Crosti associated with hepatitis caused by the  Coxsackie B4 virus]. 

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Med Clin (Barc) 1992 Jun 27;99(5):195 

[Article in Spanish] 

Ruiz de Erenchun F, Roman J, Villaizan C, Quintanilla E 

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DATA-MÉDICOS/DERMAGIC-EXPRESS No (69) 08/09/99 DR. JOSÉ LAPENTA R. 

UPDATED 04 JUNE 2025

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Produced by Dr. José Lapenta R. Dermatologist

Venezuela 1.998-2.025

Producido por Dr. José Lapenta R. Dermatólogo Venezuela 1.998-2.025

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