Case Report

Successful Treatment of Recalcitrant Granuloma Gluteale Infantum with Topical Tacrolimus 0.03% Ointment

Table 1

Differential diagnosis of granuloma gluteale infantum with differentiating features.

ConditionCharacteristics

Jacquet erosive diaper dermatitisWell-demarcated papules and nodules with central umbilications and punched-out ulcers in the genital or perianal areas; occurrence is usually in older patients

Pseudoverrucous papules and nodulesErythematous or gray, erosive or verrucous papules, nodules, or plaques; histopathology shows reactive acanthosis and psoriasiform epidermal hyperplasia without significant dermal infiltrate

Candidal diaper dermatitisBeefy red, erythematous rash with a scalloped border and a sharply demarcated margin in the diaper area; satellite papules and pustules along the margin are pathognomonic

Seborrheic dermatitisNonpruritic, salmon-colored or erythematous, sharply demarcated patches with yellow-white, greasy scales on the diaper area, face, and intertriginous areas; scaling and crusting of the scalp

Atopic dermatitisHistory of atopic disease; pruritic eruption (papules, papulovesicles, prominent scaling, excoriations, and lichenification); indistinct border; chronically relapsing

Perianal streptococcal dermatitisSharply circumscribed, tender perianal erythema; may be associated with rectal discomfort, rectal itching, painful defecation, and blood-streaked stools lesions

Plaque psoriasisWell-demarcated, annular, erythematous, round or oval, pruritic plaques with loosely adherent silvery-white micaceous scales; positive Auspitz sign; pitting of the nail

Bullous impetigoSharply demarcated bulla without surrounding erythema; rupture of the bulla reveals a moist erythematous base that dries to form a shiny lacquer-like appearance; a narrow rim of scale at the edge of the ruptured lesion is pathognomonic

Juvenile xanthogranulomaAsymptomatic, well-demarcated, dome-shaped, firm, rubbery, round-to-oval papule or nodule; a pink-to-red lesion with a yellow tinge initially; over time, the lesion acquires a yellow-brown or orange hue and will often flatten overtime

Molluscum contagiosumDiscrete, smooth, firm, waxy, dome-shaped papules with characteristic central dell or umbilication

Acrodermatitis enteropathicaAcral and periorificial dermatitis; diarrhea; alopecia

Nodular scabiesExtremely pruritic, erythematous nodules that can persist even after treatment of scabies; pruritus is most intense at night

Langerhans cell histiocytosisSeborrheic dermatitis-like eruption; erythematous/reddish-brown crusted/scaly papules/maculopapules/plaques/patches; eczematous lesions; bone lesion; anemia; thrombocytopenia; lymphadenopathy; hepatosplenomegaly

Maculopapular cutaneous mastocytosisPruritic, erythematous to reddish-brown macules/papules on the trunk and proximal extremities; positive Darier sign