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February 1982

Picture of the Month

Am J Dis Child. 1982;136(2):161-162. doi:10.1001/archpedi.1982.03970380073014

Denouement and Discussion 

Gianotti-Crosti Syndrome (Papular Acrodermatitis of Childhood) 

Manifestations  Major manifestations include an erythematous, papular, nonpruritic symmetrical rash located on the face, buttocks, and limbs and involving the palms and soles. The rash is commonly preceded by fever, malaise, or an upper respiratory tract infection. On occasion, the lesions may be hemorrhagic. The rash lasts two to eight weeks.This syndrome is also associated with generalized lymphadenopathy, involving especially inguinal and axillary lymph nodes. Mild hepatomegaly with elevated liver enzyme levels occurs simultaneously with the rash or one to two weeks later. Rarely, cholestatic jaundice occurs. Hepatitis B surface antigen (HBsAg) is usually present with the uncommon subtype ayw. Moderate and transient splenomegaly is occasionally present.Although the syndrome occurs in children between the ages of 6 months and 12 years, the peak frequency is from 1 to 4 years of age. The rash lasts approximately one month, and