To the Editor.—
I read with interest the article "α1-Antitrypsin Deficiency Associated With Persistent Cutaneous Vasculitis," in the Archives (114:921-924, 1978). Drs Brandrup and Ostergaard described a 2-year-old girl who had a nonpruritic generalized rash associated with protracted neonatal jaundice. The rash consisted of red papules that were particularly dense on the face and the extensor aspect of the limbs. It was determined by the authors that the 2-year-old child had a deficiency of α1-antitrypsin, which is sometimes associated with neonatal cholestasis and progresssive cirrhosis.It occurred to me that the clinical description of this patient's cutaneous eruption and liver involvement is suggestive of the Gianotti-Crosti syndrome. The Gianotti-Crosti syndrome, also known as acrodermatitis papulosa infantalis, consists of nonpruritic red papules appearing on the legs, thighs, buttocks, extensor aspects of the arms, and face. Occasionally a few lesions are seen on the trunk also. Purpuric staining
Stoller HE. Antitrypsin Deficiency vs Gianotti-Crosti Syndrome. Arch Dermatol. 1979;115(5):640. doi:10.1001/archderm.1979.04010050064039
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