Infantile papular acrodermatitis (Gianotti's disease) and intrafamilial occurence of acute hepatitis B with jaundice: age dependency of clinical manifestations of hepatitis B virus infection.

Infantile papular acrodermatitis (IPA, Gianotti's disease) is a clinical manifestation of hepatitis B virus (HBV) infection in childhood. An epidemic of of IPA occurred in Matsuyama, Japan, where 153 patients in a pediatric clinic had IPA between October 1974 and March 1977. In this period 12 mothers and two fathers of patients contracted acute hepatitis B with overt jaundice three to 14 months after their offspring had IPA. Analysis of the subtype of hepatitis B surface antigen (HBsAg) in the infants and their jaundiced mothers and/or fathers disclosed that HBV was transmitted from the infants. All of the index cases were one year old or younger, although the age of patients with IPA ranged from three months to 10 years. In approximately 40% of patients with IPA who were one year old or younger, HBs antigenemia persisted for one year. These facts suggested that the contraction of IPA in children, especially those one year old or younger, was an important route toward establishment of the carrier state of HBV which maintains the reservoir of this virus in the community.