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a pattern of symptoms indicative of some disease
a complex of concurrent things; "every word has a syndrome of meanings"

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(疾患の徴候となる一群の)症徴候,症候群 / (事件・社会的状態などのパターンを示す)徴候形態

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2015/03/12 06:37:21」(JST)

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Gianotti–Crosti syndrome (also known as "Infantile papular acrodermatitis,"^[1] "Papular acrodermatitis of childhood,"^[1] and "Papulovesicular acrolocated syndrome"^[2]^:389) is a reaction of the skin to a viral infection.^[3] Hepatitis B^[4] and Epstein-Barr virus are the most frequently reported etiologies. Other incriminated viruses are hepatitis A, hepatitis non A-non B, strep, cytomegalovirus,^[5] coxsackie, adenovirus, enterovirus, rotavirus, rubella, HIV and parainfluenza.^[6]

It is named for Ferdinando Gianotti and Agostino Crosti.^[7]^[8]

§Clinical features

Gianotti–Crosti syndrome mainly affects infants and young children. Children of age as low as 1.5 months and up to 12 years of age are reported to be affected.^[9] It is generally recognized as a papular or papulovesicular skin rash occurring mainly on the face and distal aspects of the four limbs. Purpura is generally not seen but may develop following application of tourniquet. However extensive purpura without any hemorrhagic disorder has been reported.^[9] The presence of less florid truncal lesions does not exclude the diagnosis. Lymphadenopathy and hepatomegaly are sometimes noted. Raised liver transaminases with no rise in conjugated and unconjugated bilirubin are sometimes detectable, although the absence of such does not exclude the diagnosis. Spontaneous disappearance of the rash usually occurs after 15–60 days.

§Diagnosis

The diagnosis of Gianotti–Crosti syndrome is clinical. A validated diagnostic criteria^[10]^[11]^[12] is as follows:

A patient is diagnosed as having Gianotti–Crosti syndrome if:

On at least one occasion or clinical encounter, he/she exhibits all the positive clinical features,
On all occasions or clinical encounters related to the rash, he/she does not exhibit any of the negative clinical features,
None of the differential diagnoses is considered to be more likely than Gianotti–Crosti syndrome on clinical judgment, and
If lesional biopsy is performed, the histopathological findings are consistent with Gianotti–Crosti syndrome.

The positive clinical features are:

Monomorphous, flat-topped, pink-brown papules or papulovesicles 1-10mm in diameter.
At least three of the following four sites involved – (1) cheeks, (2) buttocks, (3) extensor surfaces of forearms, and (4) extensor surfaces of legs.
Being symmetrical, and
Lasting for at least ten days.

The negative clinical features are:

Extensive truncal lesions, and
Scaly lesions.

§Differential diagnosis

The differential diagnoses are: acrodermatitis enteropathica, erythema infectiosum, erythema multiforme, hand-foot-and-mouth disease, Henoch-Schönlein purpura, Kawasaki disease, lichen planus, papular urticaria, papular purpuric gloves and socks syndrome, and scabies.

§Treatment

Gianotti-Crosti disease is a harmless and self-limiting condition, so no treatment may be required.^[13] Treatment is mainly focused on controlling itching, symptomatic relief and to avoid any further complications. For symptomatic relief from itching, oral antihistamines or any soothing lotions like calamine lotion or zinc oxide may be used. If there are any associated conditions like streptococcal infections, antibiotics may be required.^[10]^[11]^[12]^[13]

§See also

List of cutaneous conditions

§References

^ ^a ^b Rapini, Ronald P.; Bolognia, Jean L.; Jorizzo, Joseph L. (2007). Dermatology: 2-Volume Set. St. Louis: Mosby. p. 1228. ISBN 1-4160-2999-0.
^ James, William D.; Berger, Timothy G.; et al. (2006). Andrews' Diseases of the Skin: clinical Dermatology. Saunders Elsevier. ISBN 0-7216-2921-0.
^ "Gianotti-crosti syndrome, papulovesicular acrodermatitis. DermNet NZ".
^ Michitaka K, Horiike N, Chen Y, et al. (August 2004). "Gianotti-Crosti syndrome caused by acute hepatitis B virus genotype D infection". Internal Medicine (Tokyo, Japan) 43 (8): 696–9. doi:10.2169/internalmedicine.43.696. PMID 15468968.
^ Haki M, Tsuchida M, Kotsuji M, et al. (October 1997). "Gianotti-Crosti syndrome associated with cytomegalovirus antigenemia after bone marrow transplantation". Bone Marrow Transplantation 20 (8): 691–3. doi:10.1038/sj.bmt.1700945. PMID 9383234.
^ Chandrasekaran M, Mukherjee S (September 2007). "Gianotti Crosti syndrome". Indian Pediatrics 44 (9): 695. PMID 17921560.
^ synd/4051 at Who Named It?
^ CROSTI A, GIANOTTI F (November 1957). "[Eruptive dermatosis of probable viral origin situated on the acra.]". Dermatologica (in French) 115 (5): 671–7. PMID 13500859.
^ ^a ^b Sarma, N; Sarkar UK (Jan–Mar 2013). "Hemorrhagic Gianotti-Crosti Syndrome in a One and Half Month old Infant: An Extremely Unusual Presentation". Ind J Dermatol 58 (1): 65–67. doi:10.4103/0019-5154.105313.
^ ^a ^b Chuh, AA (September 2001). "Diagnostic criteria for Gianotti-Crosti syndrome: a prospective case-control study for validity assessment.". Cutis; cutaneous medicine for the practitioner 68 (3): 207–13. PMID 11579787.
^ ^a ^b Chuh, Antonio; Lee, Albert; Zawar, Vijay (1 September 2004). "The Diagnostic Criteria of Gianotti-Crosti Syndrome: Are They Applicable to Children in India?". Pediatric Dermatology 21 (5): 542–547. doi:10.1111/j.0736-8046.2004.21503.x. PMID 15461758.
^ ^a ^b Chuh, Antonio; Zawar, Vijay; Law, Michelle; Sciallis, Gabriel (2 January 2012). "Gianotti-Crosti syndrome, pityriasis rosea, asymmetrical periflexural exanthem, unilateral mediothoracic exanthem, eruptive pseudoangiomatosis and papular-purpuric gloves and socks syndrome: a brief review and arguments for diagnostic criteria". Infectious Disease Reports 4 (1). doi:10.4081/idr.2012.e12. PMID 24470919.
^ ^a ^b "Gianotti-crosti syndrome. Dermatalk".

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1. ジアノッティ・クロスティ症候群（丘疹性末端皮膚炎） gianotti crosti syndrome papular acrodermatitis
2. 急性痘瘡状苔癬状粃糠疹（PLEVA） pityriasis lichenoides et varioliformis acuta pleva
3. 小児におけるヒトヘルペスウイルス6感染：臨床症状、診断および治療 human herpesvirus 6 infection in children clinical manifestations diagnosis and treatment
4. ヒトパルボウイルスB19感染の臨床症状および病因 clinical manifestations and pathogenesis of human parvovirus b19 infection
5. 小児におけるB型肝炎ウイルス感染の概要 overview of hepatitis b virus infection in children

English Journal

A case of acquired zinc deficiency.

Bae-Harboe YS, Solky A, Masterpol KS.SourceBoston University School of Medicine, Department of Dermatology, Boston, Massachusetts.
Dermatology online journal.Dermatol Online J.2012 May 15;18(5):1.
We report a case of adult-onset acquired zinc deficiency after bariatric surgery. Zinc deficiency may be inherited in the form of acrodermatitis enteropathica or acquired by low nutritional intake, malabsorption, excessive loss of zinc, or a combination of these factors.
PMID 22630571

[The variable spectrum of cutaneous Lyme borreliosis : Diagnosis and therapy].

Hofmann H.SourceKlinik für Dermatologie und Allergologie, Technische Universität München, Biedersteinerstr. 29, 80802, München, Deutschland, h.hofmann@lrz.tum.de.
Der Hautarzt; Zeitschrift für Dermatologie, Venerologie, und verwandte Gebiete.Hautarzt.2012 May;63(5):381-9.
Lyme borreliosis can affect almost all human organs. Erythema migrans is the first and most frequent manifestation in 80-90% of patients in the early stage of localized skin infection. Besides the typical clinical appearance, many atypical variants can be observed. The solitary borrelial lymphocytom
PMID 22573314

Japanese Journal

成人発症のB型肝炎ウイルスに関連したGianotti-Crosti症候群の1例

本間雄一,原田大,日浦政明,成田竜一,阿部慎太郎,田原章成
肝臓 51(11), 615-619, 2010
… S/CO，HBe抗体0.0％，IgG-HBc抗体は原液96.0％，200倍希釈16.4％でありB型急性肝炎と診断した．また経過から皮疹はB型急性肝炎に伴うGianotti-Crosti症候群と診断した．入院にて，肝炎の改善とともに皮疹の消退を認めた．Gianotti-Crosti症候群は小児に多く，成人では比較的稀と認識されているが，成人での報告もある．近年，本邦では稀であった成人のB型急性肝炎 …
NAID 130000445374