Papular acrodermatitis of childhood; Gianotti-Crosti syndrome; Acrodermatitis - infantile lichenoid; Acrodermatitis - papular infantile; Papulovesicular acro-located syndrome; Acrodermatitis enteropathica
The cause of acrodermatitis is poorly understood, but its link with other infections is well-documented.
In Italian children, acrodermatitis is seen frequently with hepatitis B, but this link is rarely seen in the United States. Epstein-Barr virus (EBV, mononucleosis) is the virus most often associated with acrodermatitis. Other associated viruses inclcude, cytomegalovirus, coxsackie viruses, parainfluenza virus, respiratory syncytial virus (RSV), and some live virus vaccines.
A rare, genetic form of acrodermatitis is acrodermatitis enteropathica. In this disorder, zinc is poorly absorbed from the diet. Adding zinc supplements to the diet improves the condition. This form of the disorder can be associated with other abnormalities and development delays.
- Rash or patch on skin
- Brownish-red or copper-colored patch that is firm and flat on top
- String of bumps may appear in a line
- Generally not itchy
- Rash looks the same on both sides of the body
- Rash may appear on the palms and soles -- it does not occur on the back, chest, or belly area (this is one of the ways it is identified -- by the absence of the rash from the trunk of the body)
Other symptoms that may appear include:
Exams and tests
Your doctor can diagnose this condition by looking at the skin and rash. The liver, spleen, and lymph nodes may be swollen.
The following tests may be done to confirm the diagnosis or rule out other conditions:
- Bilirubin level
- Hepatitis virus serology or hepatitis B surface antigen
- Liver enzymes (liver function tests)
- Screening for EBV antibodies
- Serum zinc level may be tested in acrodermatitis enteropathica
- Skin biopsy
Acrodermatitis by itself is not treated. Infections associated with this condition, such as hepatitis B and Epstein-Barr, are treated. Cortisone creams may help with itching and irritation.
Acrodermatitis enteropathica improves when the zinc levels in the body is returned to normal.
Acrodermatitis usually disappears on its own without treatment or complication. Associated conditions must be watched carefully.
Complications occur as a result of associated conditions, rather than as a result of acrodermatitis.
When to Contact a Medical Professional
Call your health care provider if your child has signs of this condition.
Mancini AJ, Shani-Adir A. Other viral diseases. In: Bolognia JL, Jorizzo JL, Schaffer JV, eds. Dermatology. 3rd ed. Philadelphia, Pa: Elsevier Saunders; 2012:chap 81.
Morelli JG. Nutritional dermatoses. In: Kliegman RM, Stanton BF, St. Geme, JW III, et al., eds. Nelson Textbook of Pediatrics. 19th ed. Philadelphia, Pa: Elsevier Saunders; 2011: chap 663.
Last reviewed 5/15/2013 by Kevin Berman, MD, PhD, Atlanta Center for Dermatologic Disease, Atlanta, GA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Bethanne Black, and the A.D.A.M. Editorial team.
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