Gianotti–Crosti syndrome in a postpartum adult

Abstract

A 28-year-old Hispanic woman who was three weeks postpartum presented with a 5-day history of pruritic rash and a 2-day history of arthralgia and sore throat. Her pregnancy was complicated by pre-eclampsia at term, and she had a Cesarean delivery. The rash first appeared on the shoulders and spread centrifugally to the arms, thighs, and legs. Arthralgia began in the small joints of the hands and progressed to involve the wrists and shoulders.At presentation, the rash involved the extensor arms and legs with monomorphous, edematous, pink papules (3-4 mm) in a linear configuration (Fig. 1). The trunk was spared. Biopsy specimens were obtained from lesional and perilesional skin on the left arm. Direct immunofluorescence performed on the perilesional specimen was negative for autoimmune blistering disorders. Microscopic examination of a representative lesion showed prominent epidermal spongiosis, papillary dermal edema, and perivascular lymphocytic inflammation involving the superficial and deep dermis (Fig. 2). The clinical and histopathologic features supported a diagnosis of Gianotti-Crosti syndrome (GCS).Serologic testing was negative for Epstein-Barr virus, parvovirus B19, hepatitis B or C, Coccidioides spp., Mycoplasma spp., rapid plasma reagin, Neisseria gonorrhoeae, Chlamydia trachomatis, and Streptococcus spp. An autoimmune evaluation showed normal levels of antinuclear antibody, cyclic citrullinated peptide, C-reactive protein, anti-SSA/Ro antibodies, anti-SSB/La antibodies, and double-stranded DNA.

Gianotti-Crosti Syndrome in a Child with Recent Covid-19 Infection: A Case Report

“…Gianotti-Crosti syndrome is more frequent among children between 1 and 6 years of age [12,13]. Few cases were diagnosed in adolescents and, rarely, in adults [14][15][16][17]. The diseases frequency is nearly equal among male and female children, while in adulthood, the disease is more frequent in females [3,5,17].…”

Gianotti-Crosti syndrome: a case report of a teenager

“…It is described as an infant dermatosis, but rare cases have been reported in adults, mostly females. 7 This syndrome can be found worldwide, but its impact is unknown, due to its underdiagnosis. 1 , 3 GCS affects children of all genders and races, and can be mistakenly diagnosed as a viral rash.…”

“…Diagnosis is clinical. 1 , 2 , 4 , 7 It may be atypical in adults; due to its rare occurrence, it should be included in the differential diagnosis for molluscum contagiosum, papular urticaria, drug eruption, and erythema multiforme. 1 , 3 , 5 Changes in liver profile might be caused by hepatitis or EBV.…”

“… 1 , 5 , 6 Histopathologic findings are non-specific, and include: acanthosis, hyperkeratosis, focal parakeratosis, spongiosis, edema of the papillary dermis with extravasation of erythrocytes, superficial perivascular lymphohistiocytic inflammatory infiltrate, and dilated dermal capillaries. 1 , 3 , 7 …”

“…Antihistamines may be prescribed to control itching, and systemic corticosteroids are recommended in acute cases. 1 , 3 , 6 , 7 …”