The Gianotti-Crosti syndrome, papular acrodermatitis of childhood (PAC), is an infrequently recognized disorder with distinctive characteristics. At present hepatitis B virus is thought to be an etiologic agent. The disease is very rare in Korea, in spite of the high frequency of hepatitis B surface antigen (HBsAg) in the general population. It is known that subtype ayw of the HBsAg may influence the pathogenesis of PAC, but subtype analysis of HBsAg in these patients disclosed adr. Therefore, our studies reconfirmed that PAC may in addition be associated with subtype adr of HBsAg. We believe that the lower incidence of PAC in Korea as compared with the high incidence of PAC in other parts of the world, such as in the Mediterranean area, may be due to the fact that a higher predisposition to PAC is conferred by subtype ayw of HBsAg.
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