Chuh listed diagnostic criteria for Gianotti-Crosti Syndrome (GCS). The author is from the University of Hong Kong.


Synonym: infantile papular acrodermatitis, papular acrodermatitis of childhood


Diagnostic features – all of the following on at least one occasion::

(1) monomorphous, pink-to-brown, flat-topped papules or papulovesicles (erythematopapular dermatitis)

(2) The skin lesions are symmetrical.

(3) The skin lesions are present for at least 10 days (usually about 3 weeks).

(4) The skin lesions involve at least 3 of the following sites: cheeks, extensor surfaces of forearms, buttocks, extensor surfaces of legs (localized to face and limbs).

(5) The patient does not show any negative clinical findings related to the rash.

(6) There are no features that exclude the diagnosis (see below).


Supportive findings: Biopsy findings consistent with GCS


Additional clinical features :

(1) It is usually seen during infancy and childhood, but it can occur in adults.

(2) It may be associated with viral hepatitis, EBV or other infection.

(3) There may be a reactive lymphadenopathy with paracortical hyperplasia.

(4) The Koebner phenomenon (linear array of lesions following trauma) may be present.

(5) Hepatosplenomegaly may be present in cases associated with a systemic infection.

(6) The patient may have a concurrent skin condition (mixed disorder).


Features excluding the diagnosis:

(1) extensive lesions on the trunk

(2) scaly lesions

(3) an alternative diagnosis explains the findings better (acrodermatitis enteropathica, erythema infectiosum, hand-foot-mouth disease, Kawasaki disease, lichen plans, papular purpuric gloves-and-socks syndrome, scabies, papular urticaria, erythema multiforme, Henoch-Schonlein purpura)


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