A few days ago some very concerned parents came to my office because their 4-year-old daughter had a skin rash on the face and upper and lower limbs of 2 days of evolution. By doing the physical exam and getting the history, I concluded that it was the Gianotti-Crosti syndrome, a skin disease that, although initially scary, is benign.
The skin is the largest organ of the body and it is the one that is most exposed to the environment and to all the external agents that can stalk our body, so when our children present any skin pathology, as parents it generates a lot of anguish and we quickly consult the pediatrician to find out what it is.
He Gianotti-Crosti syndrome It is a rare and self-limited skin disease that mainly affects children between 3 months and 12 years (in some up to 15 years), with a predominant age between 1 and 6 years and that affects both sexes equally.
Also known as 'papular acrodermatitis of childhood' or 'acrolocalized papulovesicular syndrome', it is a contagious pathology before the skin breakout, but after the rash appears, it is no longer contagious.
The form of contagion of this disease is still unknown, however, it is usually associated with an infection of viral origin, for example, hepatitis B virus, cytomegalovirus, epstein bar, coxsackie virus, parainfluenza, respiratory syncytial virus, parvovirus b_19 or herpes virus type 6.
It is also associated with vaccination with live virus serum, such as diphtheria, tetanus, pertussis, hepatitis, triple viral or BCG.
Like my patient, they are children who, prior to the appearance of the skin lesions, more or less 2 to 7 days before, may have catarrhal symptoms, with poor appetite, low-grade fever, tiredness and lymphadenopathy in the neck, but the characteristic picture is a typical dermatitis in a single outbreak, with asymptomatic papulo-vesicular lesions, that is, they do not produce any discomfort.
Its distribution is symmetrical and the location is acral, being found on extensor surfaces of the hands, arms and legs, and then in 2 to 3 days it appears on the buttocks, face and neck. They are raised lesions, like 1 to 5 mm pink-brown granites.
It respects the trunk, mucous membranes and nails and, as I said before, this rash does not usually bother and children may feel a slight itch at all. As for complications, they are very rare, but in cases related to the Hepatitis B virus, the patient can suffer from the disease. And where the lesions appeared, the skin can suffer a decrease in pigmentation, which recovers in several months.
The diagnosis of this syndrome is practically made with the patient's clinic and knowing the pathological history prior to the appearance of the lesions, which was what helped me in the case of my patient to reach the diagnosis to reassure the parents, since I informed them that it was a benign, self-limited disease with very few complications.
We could request laboratory tests only in the case of suspecting that the child has a viral disease type Hepatitis B as a history, otherwise paraclinics would not be necessary to reach a diagnosis of Gianotti-Crosti Syndrome.
For the peace of mind of the parents, treatment that I indicated to my patient it was practically symptomatic: antipyretic or antipyretic, if there is a low-grade fever, rest and plenty of oral fluids. It is actually a self-limited disease that does not require specific treatment.
If the lesions cause some itching, an oral antihistamine will be indicated and calamine applied to the skin, several times a day.
Finally, I will give you some recommendations that parents should take into account when their children are ill with this or any other pathology:
- Consult immediately with the pediatrician, that is, do not wait for complications to appear.
- Do not self-medicate and less if you have no idea what dose corresponds to it according to its weight.
- Do not administer infusions or herbal teas that can cause poisoning and aggravate the clinical picture of the patient, including its vitality.
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