Acrodermatitis
Acrodermatitis, also known as papular acrodermatitis or Gianotti-Crosti syndrome, is a skin disease of early childhood. While its exact causes are unknown, research suggests that acrodermatitis may be caused by certain viral infections, such as the Epstein-Barr virus. Most commonly an acquired disorder, acrodermatitis may, in rare cases, be genetic. Acrodermatitis typically heals on its own in 2 to 4 weeks, although it may last for several months or even years. The disorder is believed to be slightly contagious. Medical attention is required to determine and treat underlying conditions.
Causes of Acrodermatitis
While the cause of acrodermatitis is not yet known, the disorder has been linked to certain viral infections. In the United States, connections have been observed between acrodermatitis and the following:
- Epstein-Barr, also know as mononucleosis
- Cytomegalovirus
- Coxsackie viruses
- Parainfluenza virus
- Respiratory syncytial virus
- Echo viruses
- Some live virus vaccines
For unknown reasons, in Italy, acquired acrodermatitis has been tied to hepatitis B, though this link has not been observed in the United States.
When acrodermatitis appears in its genetic form, it is known as acrodermatitis enteropathica. In this form of the disease, the patient is incapable of absorbing zinc properly, even when sufficient amounts of the mineral are ingested as part of the diet. Patients with this form of the disease also suffer gastrointestinal disturbances, particularly diarrhea, and other abnormalities may be apparent, including developmental delays.
Symptoms of Acrodermatitis
The chief presenting symptom of acrodermatitis is a rash on the palms and soles of the feet that may spread to the face. This rash is notable for the fact that it does not appear on the torso and also that it does not generally itch. The rash may become pustular, with fluid-filled blisters, and may be accompanied by a firm, flat, brownish patch on the skin. The rash of acrodermatitis is sometimes symmetrical.
Other symptoms of acrodermatitis may include:
- Fever and malaise
- Abdominal swelling
- Swollen, tender lymph nodes
- Swollen liver and spleen
Diagnosis of Acrodermatitis
Acrodermatitis is diagnosed by a medical examination of the skin. In order to rule out other causes for the patient's rash, the physician may prescribe one or more of the following diagnostic tests:
- Liver function tests
- Skin biopsy
- Blood tests for zinc level, bilirubin, hepatitis antigens
- Epstein-Barr antibody screening
Treatment of Acrodermatitis
While there is no treatment for acquired acrodermatitis and it normally resolves on its own. Underlying viral infections, such as Epstein-Barr and hepatitis, require medical treatment. In the case of acrodermatitis enteropathica, zinc supplements are helpful.