Gianotti-Crosti Syndrome

Gianotti-Crosti syndrome is a relatively common rash affecting children worldwide. Almost all patients are between 3 months and 15 years of age, most commonly between 1 and 6 years of age. It affects males and females equally.

It is most commonly a red bumpy rash, which is usually not itchy or painful. It starts suddenly, sometimes following a sore throat, low-grade fever, cough/cold symptoms, or diarrhea. The rash is usually symmetric and found on the cheeks, arms, legs, and buttocks. The trunk, knees, elbows, palms, and soles are commonly not involved. The rash can last for several weeks.

The cause of Gianotti-Crosti syndrome is unknown, although a number of hypotheses have been proposed. It sometimes occurs in association with viral or bacterial infections, as well as recent immunizations. At one time, hepatitis B virus was thought to be the most common virus associated with Gianotti-Crosti syndrome, but it is now thought that Epstein-Barr virus is the most common. Other viruses implicated include hepatitis A and C, cytomegalovirus, human herpesvirus 6, coxsackievirus, rotavirus, parvovirus, molluscum contagiosum, respiratory syncytial virus, echovirus, mumps, parainfluenza, and human immunodeficiency virus. Bacterial associations include Bartonella henselae, β-hemolytic streptococci, Borrelia burgdorferi, and Mycoplasma pneumoniae. It has also been long known that there is an association between Gianotti-Crosti syndrome and vaccination with the rash appearing days to weeks after immunization.

Gianoti-Crosti syndrome is benign and self-limited, although it may last for several weeks. It typically is not itchy and does not have any symptoms, and thus treatment is often not needed. If itchy or bothersome, topical corticosteroids (i.e. hydrocortisone), oral antihistamines, or topical anti-itch medications can be useful.

Brandt O, Abeck D, Gianotti R, Burgdorf W. Gianotti-Crosti syndrome. J Am Acad Dermatol 2006;54:136-45.

Gregg Severs, D.O.
Department of Dermatology
Philadelphia College of Osteopathic Medicine/Frankford Hospital
Philadelphia, Pennsylvannia.