Gianotti F
Padiatr Padol. 1977;12(1):58-62.
Several items characterize the papular acrodermatitis: 1. the clinical picture and the localisation 2. inguinal and axillary lymphadenitis 3. acute usually anicteric hepatitis 4. presence of hepatitis B antigen in all patients. Other members of the family are carriers of HB-Ag, too. One of them usually had icteric hepatitis weeks before or after PAC. At present we consider PAC as the clinical disease due to the primary infection of HB-Ag in childhood. The cycle of HB Ag is shown in a scheme. It suggests why the disease is rare, asymptomatic infections occurring in the majority of the cases. It appears in children without HB-antibodies and a particular reactive condition. After parenteral inoculation PAC and lymphadenitis do not develop. Some chronic HB Ag carriers may have become so after PAC in the childhood.