Gianotti-Crosti syndrome: a challenging exanthema

Abstract

Gianotti-Crosti syndrome (GCS) is a self-limited condition, mainly affecting children younger than 6 years, less common in adolescents and adults. It consists of a viral exanthema with papular lesions with a flat top and symmetrical distribution, affecting predominantly extremities, gluteal region and extensor surfaces. It is often associated with viral infections but can also be related to bacterial infections, vaccination or be idiopathic. In this report, we present a case of GCS in a 13-year-old healthy female adolescent who presented with fever, odynophagia, prostration and diffuse maculopapular rash. The diagnosis of infectious mononucleosis due to infection by the Epstein-Barr virus was established. On the second week of the disease, a clinical recrudescence occurred, with worsening of the fever and modification of the exanthema characteristics. GCS is often an underdiagnosed entity. The differential diagnosis of viral exanthema can prove to be challenging and clinical suspicion is essential to achieve the diagnosis.

Keywords: infectious diseases; paediatrics (drugs and medicines); skin.

Figure 1

Maculopapular exanthema on the abdomen and back in a 13-year-old female adolescent on the third day of illness.

Figure 2

Coalescent maculopapular exanthema on the neck, back and dorsal face of the hand in a 13-year-old female adolescent on the eighth day of disease.

Figure 3

Coalescent pink-brown papulovesicular exanthema in a 13-year-old female adolescent on the 10th day of disease progression with an established diagnosis of Gianotti-Crosti syndrome.

Figure 4

Skin biopsy histopathology showing lymphocytic perivascular infiltrate, papillary dermis oedema and parakeratosis.