Gianotti–Crosti Syndrome Preceded by Oral Polio Vaccine and Followed by Varicella Infection

Abstract

Gianotti-Crosti syndrome (papular acrodermatitis of childhood) is considered a nonspecific cutaneous host response to a variety of infectious agents, particularly viruses. Herein we report a case of Gianotti- Crosti syndrome preceded by oral polio vaccine and followed by varicella infection. The present case may support the hypothesis of initial immunization and following viral infection as a possible mechanism for Gianotti-Crosti syndrome.

Gianotti-Crosti syndrome

“…Many other subsequent case reports have also documented this phenomenon days to weeks after vaccination. 26,41,[62][63][64][65][66][67] It appears that many of these children have had a clinically apparent or even subclinical viral infection at the time of their immunization (Table III). In the experience of Haug et al, 63 GCS only developed after the initial immunization and did not recur with the subsequent immunizations.…”

A case-control study on the association of pulse oral poliomyelitis vaccination and Gianotti-Crosti syndrome

“…reported one child with GCS having polio‐vaccine enterovirus detected in the stools. Erkek et al . reported one child with GCS preceded by OPV and followed by varicella infection.…”

“…Of comparable interest are the various vaccines, namely diphtheria‐pertussis‐tetanus (DTP) vaccine, measles‐mumps‐rubella vaccine, influenza virus vaccine, and oral polio vaccine (OPV) reported to be associated with GCS.…”

A case report of Gianotti‐Crosti post vaccination with MMR and dTaP

“…Others hypothesize that viral antigenemia or circulating immune complexes from the virus or vaccine are the etiology. Histopathologic findings by punch biopsy show orthokeratosis, psoriasiform hyperplasia with spongiosis, focal lymphocyte groups resembling microabscesses in epidermis, marked edema, and superficial perivascular and perifollicular lymphocyte infiltrate in the upper dermis 5 . However, the benefits of the vaccine against measles, mumps, and rubella far exceed the minor effects from the self‐limited Gianotti‐Crosti syndrome.…”