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Infantile papular acrodermatitis, identified by the ICD-11 code EA12, is a benign, self-limiting skin condition primarily affecting children. It is characterised by a distinctive rash that typically appears on the extremities, face, and buttocks. While often referred to as Gianotti-Crosti syndrome, other clinical synonyms include papular acrodermatitis of childhood and papulovesicular acrolocated syndrome. This condition is generally not associated with significant systemic illness, though it is frequently linked to preceding viral infections or vaccinations.
The hallmark symptom of infantile papular acrodermatitis is an acute eruption of small, flat-topped, pink-to-red papules. These lesions are typically monomorphic and appear symmetrically. The rash commonly begins on the thighs and buttocks, then spreads to the extensor surfaces of the arms and legs, and may also affect the face. The trunk is usually spared. Individual lesions are usually 1-10 mm in diameter. While the rash is often asymptomatic, mild itching can occur. In some cases, fluid-filled blisters (vesicles) may develop. The condition typically lasts for several weeks, resolving without scarring, although temporary post-inflammatory pigment changes can occur.
The precise cause of infantile papular acrodermatitis (ICD-11 code EA12) is not fully understood, but it is believed to be an immune response to various triggers. Historically, it was associated with Hepatitis B virus infection, but in many regions, Epstein-Barr virus (EBV) is now the most frequently identified cause. Other associated viral infections include cytomegalovirus (CMV), enteroviruses, adenoviruses, and SARS-CoV-2 (COVID-19). The condition has also been reported following vaccinations, such as those for influenza, hepatitis B, and measles. Children with a history of atopic dermatitis may be at increased risk.
The diagnosis of infantile papular acrodermatitis (EA12) is primarily clinical, based on the characteristic appearance and distribution of the rash. Diagnostic criteria often include the presence of monomorphic papules or papulovesicles on at least three of four sites (cheeks, buttocks, extensor forearms, extensor legs), symmetrical distribution, and a duration of at least 10 days, with absent extensive truncal lesions and scaling. While specific laboratory tests are not usually required, investigations such as blood counts, liver function tests, or viral serology may be considered if an underlying systemic viral illness is suspected, particularly in immunocompromised individuals or those with concerning symptoms like hepatomegaly.
Infantile papular acrodermatitis (ICD-11 code EA12) is a benign and self-resolving condition, meaning treatment is mainly supportive. Reassurance for parents regarding the condition's non-serious nature is paramount. Symptomatic relief for itching may involve emollients or oral antihistamines. Mild topical corticosteroids might be prescribed if other measures are insufficient, though they do not alter the course of the rash. Management focuses on addressing any underlying viral infection if clinically indicated. The condition typically resolves spontaneously within 2 to 8 weeks.
Infantile papular acrodermatitis (ICD-11 code EA12) is widely recognised by several other names in clinical practice. These include Gianotti-Crosti syndrome, which is perhaps the most common alternative term. Other descriptive designations that refer to the same clinical entity are papular acrodermatitis of childhood, papular acrodermatitis, papulovesicular acrolocated syndrome, and infantile acrolocalised papulovesicular syndrome.
Accurate documentation and coding are essential for healthcare providers managing infantile papular acrodermatitis. The official ICD-11 code for this condition is EA12. When documenting, clinicians should include the official condition name, 'Infantile papular acrodermatitis', along with any relevant clinical synonyms such as 'Gianotti-Crosti syndrome' or 'papular acrodermatitis of childhood'. This ensures precise medical records and facilitates correct billing and reporting. The ICD-11 code EA12 is used for diagnostic purposes and may be reportable depending on healthcare system requirements. When coding, ensure the selected code accurately reflects the diagnosed condition without broadening or substituting the diagnosis.
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