Gianotti-crosti syndrome : An atypical presentation of Hepatitis B virus infection

In children, Hepatitis B may present rarely with anicteric hepatitis, a non-pruritic papular rash on the face, buttocks and limbs, and lymphadenopathy. This is known as papular acrodermatitis of childhood or Gianotti- Crosti syndrome.  Likely pathogenesis for this condition is local type IV hypersensitivity reaction to offending viral antigen within the dermis. It is more common among children with atopic dermatitis. With the advent of global HBV vaccination, EBV is now more common pathogen for this uncommon disorder. It is a benign self limited condition which requires no treatment.

Child with acute hepatitis B infection with non pruritic papular rash