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Giannotti-Crosti Syndrome

This rash arose a week after a 6-year-old boy complained of chills, nausea, and sore throat. WHat's the cause?

A 6-year-old boy was brought for medical evaluation when he broke out with innumerable pea-sized and -shaped, asymptomatic red papulonodules on cheeks, buttocks, and upper thighs. The week before onset of the rash, the child had not been feeling well and had complained of chills, nausea, and a sore throat. One objective temperature measurement showed 102.8°F.

Key point: This morphology is classic for an entity known as Giannotti-Crosti syndrome; this eruption is typically associated with viral illness in children up to age 12, most notably: hepatitis C virus, echovirus and enterovirus infections, and recent acquisition of Epstein-Barr virus (EBV).

Treatment: There is no specific treatment. Most underlying viral illnesses slowly fade during the acute phase of this distressing disease. Topical corticosteroids can be used to alleviate itching.

Note: In the United States, EBV infections are the most common associated factor.