Gianotti-Crosti syndrome (GCS) was diagnosed in this young patient. GCS is a pediatric disease that is believed to involve a cutaneous reaction pattern related to viral and bacterial infections or to vaccination. It is associated with the hepatitis B virus, Epstein-Barr virus, enteroviruses, parainfluenza viruses, and other viral infections. The eruption has also occurred following vaccination (hepatitis A, others).
Most patients with GCS do not need treatment because it is a self-limited benign disease. Although the course is variable and the skin lesions may persist for up to 60 days, the lesions will heal without scarring.
In patients who have severe pruritus, topical antipruritic lotions or oral histamines can provide relief. Medium-potency topical steroids may have some benefit, but patients should be closely monitored because there have been reports of exacerbations of lesions with steroid use.
In the case of this patient, the lesions resolved one week after applying 0.1% mometasone furoate cream once a day.
Adapted from: Liaw FY, Huang CF, Wu LW, et al. Photo Rounds: Acral papular rash in a 2-year-old boy. J Fam Pract. 2012;61:157-159.
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