World Journal of Pediatrics

, Volume 15, Issue 6, pp 521–527 | Cite as

Gianotti–Crosti syndrome (papular acrodermatitis of childhood) in the era of a viral recrudescence and vaccine opposition

  • Alexander K. C. LeungEmail author
  • Consolato Maria Sergi
  • Joseph M. Lam
  • Kin Fon Leong
Review Article



Gianotti–Crosti syndrome is characterized by an acute onset of a papular or papulovesicular eruption with a symmetrical distribution.

Data sources

A PubMed search was conducted using Clinical Queries with the key terms “Gianotti-Crosti syndrome” OR “papular acrodermatitis”. The search strategy included meta-analyses, randomized controlled trials, clinical trials, observational studies, and reviews. This paper is based on, but not limited to, the search results.


The eruption of Gianotti–Crosti syndrome is found predominantly on the cheeks, extensor surfaces of the extremities, and buttocks. There is a sparing of antecubital and popliteal fossae as well as palms, soles, and mucosal surfaces. Although often asymptomatic, the lesions may be mildly to moderately pruritic. Gianotti–Crosti syndrome is most common in children between 1 and 6 years of age. The Epstein–Barr virus and the hepatitis B virus are the most common pathogens associated with Gianotti–Crosti syndrome. No treatment for Gianotti–Crosti syndrome is necessary because it is self-limited. In an era of vaccine hesitancy and refusal, Gianotti–Crosti syndrome may be important to mention to parents, because it can occur and trigger alarmism.


Gianotti–Crosti syndrome is mainly a disease of early childhood, characterized by an acute onset of a papular or papulovesicular eruption with a symmetrical distribution. With the advent of more universal vaccination against hepatitis B virus, Epstein–Barr virus has become the most common etiologic agent of Gianotti–Crosti syndrome. Few cases of post-vaccination Gianotti–Crosti syndrome have been reported. Currently, the emphasis should be placed on its self-limiting attribution.


Epstein–Barr virus Hepatitis B virus Papular acrodermatitis Papular symmetrical eruption 


Author contributions

AKCL wrote the first draft of the manuscript, as well as a statement of whether an honorarium, grant, or other form of payment was given to anyone to produce the manuscript. CMS, JML, and KFL contributed to drafting and revising the manuscript. The authors have seen and approved the final version submitted for publication and take full responsibility for the manuscript.


There is no honorarium, Grant, or other form of payment given to any of the author/coauthor.

Compliance with ethical standards

Ethical approval

Not applicable.

Conflict of interest

No financial or non-financial benefits have been received or will be received from any party related directly or indirectly to the subject of this article.


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© Children's Hospital, Zhejiang University School of Medicine 2019

Authors and Affiliations

  1. 1.Department of PediatricsThe University of CalgaryCalgaryCanada
  2. 2.The Alberta Children’s HospitalCalgaryCanada
  3. 3.The University of AlbertaEdmontonCanada
  4. 4.Departments of Pediatrics, Dermatology and Skin SciencesUniversity of British ColumbiaVancouverCanada
  5. 5.Pediatric InstituteKuala Lumpur General HospitalKuala LumpurMalaysia

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