Case report: Gianotti-Crosti syndrome in an adult heart transplant patient with cytomegalovirus infection.
Recommended Citation
Mancuso JB, Maxim E, Rambhatla PV. Case report: Gianotti-Crosti syndrome in an adult heart transplant patient with cytomegalovirus infection.. J Am Acad Dermatol 2018; 79(3):AB63.
Document Type
Conference Proceeding
Publication Date
9-2018
Publication Title
J Am Acad Dermatol
Abstract
A 52-year-old African-American man with a history of a heart transplant on tacrolimus, mycophenolate mofetil and prednisone presented to dermatology clinic with a papular eruption for one month. Before his dermatology visit, he was started on valgancylovir for CMV viremia. Physical examination revealed multiple hyperkeratotic skin colored, firm, monomorphous papules on the extremities, most prominent on the bilateral elbows and knees. A punch biopsy was done which showed a spongiotic epidermis with spongiotic microvesicles, parakeratosis and superficial perivascular lymphohistiocytic inflammation. Based on the histopathology and clinical constellation, the diagnosis of Gianotti-Crosti syndrome was made. The patient was treated with triamcinolone 0.1% ointment twice daily and he had complete resolution of the eruption within three weeks. Gianotti-Crosti syndrome (GCS) or papular acrodermatitis is a benign eruption that typically manifests in children as skin-colored to erythematous papules on the face and extremities which persist for 3-5 weeks. Historically, the syndrome was thought to be a manifestation of hepatitis B, but has been demonstrated to occur following various other viral illnesses and immunizations; in the United States, EBV is the most commonly reported inciting infectious etiology. Our case is unique because while GCS in infants and children is common, few cases of GCS have been reported in adults with the majority associated with hepatitis B infection. Cases of GCS after CMV infection are also rare, and have only been reported in the age range of 13 months to 6 years, but never, to our knowledge, in adults.
Volume
79
Issue
3
First Page
AB63
Comments
A 52-year-old African-American man with a history of a heart transplant on tacrolimus, mycophenolate mofetil and prednisone presented to dermatology clinic with a papular eruption for one month. Before his dermatology visit, he was started on valgancylovir for CMV viremia. Physical examination revealed multiple hyperkeratotic skin colored, firm, monomorphous papules on the extremities, most prominent on the bilateral elbows and knees. A punch biopsy was done which showed a spongiotic epidermis with spongiotic microvesicles, parakeratosis and superficial perivascular lymphohistiocytic inflammation. Based on the histopathology and clinical constellation, the diagnosis of Gianotti-Crosti syndrome was made. The patient was treated with triamcinolone 0.1% ointment twice daily and he had complete resolution of the eruption within three weeks. Gianotti-Crosti syndrome (GCS) or papular acrodermatitis is a benign eruption that typically manifests in children as skin-colored to erythematous papules on the face and extremities which persist for 3-5 weeks. Historically, the syndrome was thought to be a manifestation of hepatitis B, but has been demonstrated to occur following various other viral illnesses and immunizations; in the United States, EBV is the most commonly reported inciting infectious etiology. Our case is unique because while GCS in infants and children is common, few cases of GCS have been reported in adults with the majority associated with hepatitis B infection. Cases of GCS after CMV infection are also rare, and have only been reported in the age range of 13 months to 6 years, but never, to our knowledge, in adults.