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

World J Pediatr. 2019 Dec;15(6):521-527. doi: 10.1007/s12519-019-00269-9. Epub 2019 May 27.


Background: 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.

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.

Conclusions: 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.

Keywords: Epstein–Barr virus; Hepatitis B virus; Papular acrodermatitis; Papular symmetrical eruption.

Publication types

  • Review

MeSH terms

  • Acrodermatitis / diagnosis
  • Acrodermatitis / etiology*
  • Acrodermatitis / virology*
  • Anti-Vaccination Movement
  • Child
  • Child, Preschool
  • Humans
  • Infant
  • Recurrence
  • Vaccines / adverse effects*


  • Vaccines