Definition

Gianotti-Crosti syndrome is a childhood skin condition that may be accompanied by mild symptoms of fever and malaise. It may also be associated with hepatitis B and other viral infections.

Alternative Names

Papular acrodermatitis of childhood; Infantile acrodermatitis; Acrodermatitis - infantile lichenoid; Acrodermatitis - papular infantile; Papulovesicular acro-located syndrome

Causes

Health care providers don't know the exact cause of this disorder. They do know that it is linked with other infections.

In Italian children, Gianotti-Crosti syndrome is seen frequently with hepatitis B infection. But this link is rarely seen in the United States. Epstein-Barr virus (EBV, mononucleosis) is the virus most often associated with acrodermatitis.

Other associated viruses include:

• Cytomegalovirus
• Coxsackie viruses
• Parainfluenza virus
• Respiratory syncytial virus (RSV)
• Some types of live virus vaccines

Bacterial infections such as Group A streptococcus and mycoplasma pneumoniae may also be associated with acrodermatitis.

Symptoms

Skin symptoms may include any of the following:

• Rash or patch on the skin, usually on the arms and legs
• Brownish-red or copper-colored patch that is firm and flat on top
• String of bumps may appear in a line
• Generally not itchy
• Rash looks the same on both sides of the body
• Rash may appear on the palms and soles, but not on the back, chest, or belly area (this is one of the ways it is identified, by the absence of the rash on the trunk of the body)

Other symptoms that may appear include:

• Swollen abdomen
• Swollen lymph nodes
• Tender lymph nodes

Exams and Tests

Your provider can diagnose this condition by looking at your skin and rash. Your liver, spleen, and lymph nodes may be swollen.

The following tests may be done to confirm the diagnosis or rule out other conditions:

• Blood bilirubin level
• Hepatitis virus serology or hepatitis B surface antigen
• Liver enzymes (liver function tests)
• Screening for EBV antibodies
• Skin biopsy

Treatment

The disorder itself is not treated. Infections linked with this condition, such as hepatitis B and Epstein-Barr, are treated. Hydrocortisone creams and oral antihistamines may help with itching and irritation.

Outlook (Prognosis)

The rash usually disappears on its own in about 3 to 8 weeks without treatment or complication. Associated conditions must be watched carefully.

Possible Complications

Complications occur as a result of associated conditions, rather than as a result of the rash.

When to Contact a Medical Professional

Contact your provider if your child has signs of this condition.

References

Dhossche JM, Chiu YE. Eczematous disorders. In: Kliegman RM, St. Geme JW, Blum NJ, et al, eds. Nelson Textbook of Pediatrics. 22nd ed. Philadelphia, PA: Elsevier; 2025:chap 696.

Mancini AJ, Shani-Adir J, Sidbury R. Other viral diseases. In: Bolognia JL, Schaffer JV, Cerroni L, eds. Dermatology. 5th ed. Philadelphia, PA: Elsevier; 2025:chap 81.