Dytoc Marlene T, Fiorillo Loretta, Liao Janice, Krol Alfons L
Division of Dermatology and Cutaneous Sciences, University of Alberta, Edmonton, Alberta, Canada.
J Cutan Med Surg. 2002 May-Jun;6(3):221-5. doi: 10.1007/s10227-001-0042-9. Epub 2002 May 13.
Granuloma gluteale infantum is a skin disorder of controversial etiology manifested clinically by oval reddish-purple granulomatous nodules on the gluteal surfaces and groin areas of infants. Similar granulomas are noted in adults and the elderly and are referred to as granuloma gluteale adultorum and diaper area granuloma of the aged, respectively. Occlusion from diapers, paper napkins, plastic pants, detergents, starch, powder, halogenated steroids, candidal infection, and urine and feces are postulated as possible etiologies.
We report a case of a 40-year-old woman presenting with a 3-year history of multiple, painful, closely set, red-purple, oval, smooth, firm papules and nodules in the genitocrural area. The development of the lesions was associated with prolonged use of topical benzocaine. Histology of the lesions was consistent with granuloma gluteale infantum. Gram stain and culture of representative tissue did not demonstrate bacterial or fungal organisms. The lesions significantly improved with discontinuation of topical benzocaine. Patch testing of skin to determine allergic contact hypersensitivity to benzocaine was negative.
We propose that topical benzocaine preparations may play a role in the pathogenesis of granuloma gluteale adultorum, independent of contact sensitization to benzocaine.
婴儿臀部肉芽肿是一种病因存在争议的皮肤疾病，临床特征为婴儿臀部和腹股沟区域出现椭圆形红紫色肉芽肿性结节。成人和老年人也会出现类似的肉芽肿，分别称为成人臀部肉芽肿和老年人尿布区肉芽肿。尿布、纸巾、塑料裤、洗涤剂、淀粉、粉末、卤化类固醇、念珠菌感染以及尿液和粪便的阻塞被认为是可能的病因。
我们报告一例40岁女性病例，其在生殖股区域出现多个疼痛、密集分布的红紫色椭圆形光滑坚实丘疹和结节，病程3年。病变的发展与长期使用外用苯佐卡因有关。病变的组织学表现与婴儿臀部肉芽肿一致。代表性组织的革兰氏染色和培养未发现细菌或真菌。停用外用苯佐卡因后病变明显改善。对皮肤进行斑贴试验以确定对苯佐卡因的过敏性接触超敏反应为阴性。
我们认为外用苯佐卡因制剂可能在成人臀部肉芽肿的发病机制中起作用，与对苯佐卡因的接触致敏无关。
