What are the other Names for this Condition? (Also known as/Synonyms)

• Vegetating Bromidism (formerly)
• Vegetating Potassium Bromide Toxic Dermatitis (formerly)

What is Granuloma Gluteale Infantum? (Definition/Background Information)

• Granuloma Gluteale Infantum may be described as a rare complication of diaper dermatitis that is observed in infants. Diaper dermatitis or napkin dermatitis (napkin rash) is a form of irritant contact dermatitis that affects babies using diapers, at the area of skin contact
• Irritant contact dermatitis is a medical condition in which the skin gets damaged and inflamed due to exposure to chemicals or substances that irritate the outer protective layer of skin
• Granuloma Gluteale Infantum results in firm red-to-violet-colored nodules in the groin, upper thighs, and buttocks. This may lead to bacterial or fungal infection. Also, following resolution of this condition, atrophic scarring is noted
• The treatment of Granuloma Gluteale Infantum may be challenging since it is resistant to conventional topical creams and anti-inflammatory applications. Nevertheless, even without treatment, the condition is known to get better within about 2 months. The prognosis is generally good with appropriate intervention

Who gets Granuloma Gluteale Infantum? (Age and Sex Distribution)

• Granuloma Gluteale Infantum is a rare skin condition that is observed in infants up to 9 months old (mean age around 6 months)
• Both males and females are affected by this condition, although a greater number of cases are observed in boys
• Worldwide, no racial or ethnic group preference is noted

What are the Risk Factors for Granuloma Gluteale Infantum? (Predisposing Factors)

• The primary risk factor for Granuloma Gluteale Infantum is the use of napkins/diapers in infant children
• Children with chronic diarrhea or urinary/bowel incontinence may present an aggravated condition

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases one’s chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Granuloma Gluteale Infantum? (Etiology)

Granuloma Gluteale Infantum is a type of irritant contact dermatitis that is associated with diaper/napkin dermatitis. The exact cause of the condition is unknown since the correlation between Granuloma Gluteale Infantum and diaper dermatitis is not well-understood. Also, very few cases of diaper dermatitis are known to result in Granuloma Gluteale Infantum.

Some of the factors believed to be associated with the condition include:

• Treatment of diaper dermatitis using medications such as steroidal creams and topical anesthetics
• Prolonged blockage of skin pores by the diaper
• Fungal infection (particularly due to Candida albicans)

What are the Signs and Symptoms of Granuloma Gluteale Infantum?

The signs and symptoms of Granuloma Gluteale Infantum can be mild or severe and may include:

• Presence of red to violet skin lesions
• The lesions are often firm and nodular (oval-shaped) and lie along the lines of the skin folds, mostly in the groin region and between the inner thighs
• Other areas that may show the nodules include the buttocks and genitalia (scrotum in boys)
• Sometimes, an extensive area of the skin may be involved (including showing bilateral and symmetric presentation)
• The size of the nodules may vary from 5 to 40 mm
• Pain and discomfort is usually not seen (typically, if ulceration is absent)
• Erosion and ulceration of the skin surface may be noted in some infants
• If a secondary infection develops, such as bacterial or fungal infection, the area of involvement may spread to non-contact areas too

How is Granuloma Gluteale Infantum Diagnosed?

A diagnosis of Granuloma Gluteale Infantum would include:

• A complete evaluation of one’s medical history and a thorough physical examination to observe the signs and symptoms
• Culture studies through skin swabs to detect any bacterial or fungal infection
• Dermoscopy: Dermoscopy is a diagnostic tool where a dermatologist examines the skin using a special magnified lens
• Wood’s lamp examination: In this procedure, the healthcare provider examines the skin using ultraviolet light. It is performed to examine the change in skin pigmentation
• Skin biopsy: A skin tissue biopsy is performed and sent to a laboratory for a pathological examination. The pathologist examines the biopsy under a microscope. After putting together clinical findings, special studies on tissues (if needed) and with microscope findings, the pathologist arrives at a definitive diagnosis

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Granuloma Gluteale Infantum?

Granuloma Gluteale Infantum could lead to the following complications namely:

• Emotional stress for the parents and caregivers
• Bacterial and fungal infection: Continuous itching and scaling of the skin will create skin moistness, providing a suitable environment for bacteria and fungi to grow and thrive
• Darker skin following resolution of the condition (post-inflammatory hyperpigmentation)
• Atrophic scarring
• Recurrence of the condition
• Resistance of the condition to treatment

How is Granuloma Gluteale Infantum Treated?

In general, it is difficult to treat Granuloma Gluteale Infantum since the use of topical applications and steroids are not effective. However, the condition may be managed through the following measures:

• Diaper-related:
  • Minimizing the use of diapers, as much as is practically possible
  • Frequently changing diapers; keeping the pelvic region ‘diaper-free’ for certain periods of time
  • Washing and cleaning the pelvic region; and then, keeping it dry and adequately ventilated
  • Use of good quality disposable diapers; breathable diapers that are hypoallergenic and superabsorbent
• Administration of antifungal or antibiotic medication for secondary infections
• In case of severe symptoms, systemic therapy may be necessary
• Undertaking treatment of any other skin conditions

How can Granuloma Gluteale Infantum be Prevented?

Promptly recognizing and treating diaper dermatitis may help avoid the development of Granuloma Gluteale Infantum.

What is the Prognosis of Granuloma Gluteale Infantum? (Outcomes/Resolutions)

Granuloma Gluteale Infantum usually resolves within a few months, even in the absence of treatment. However, it is important to recognize the condition and appropriately manage the signs and symptoms.

Additional and Relevant Useful Information for Granuloma Gluteale Infantum:

The following article link will help you understand contact dermatitis:

http://www.dovemed.com/diseases-conditions/contact-dermatitis/