Department of Dermatology, Nara Hospital, Kinki University School of Medicine, Nara, Japan.
J Dermatol. 2013 Dec;40(12):1038-41. doi: 10.1111/1346-8138.12337. Epub 2013 Dec 4.
An infant skin disease with clusters of nodules in the diaper contact area was reported as granuloma gluteale infantum. Recently, the number of elderly patients with this condition has increased, and it has been reported as diaper-area granuloma of the aged. These lesions are presumably caused by irritation from feces and urine. We observed similar cutaneous symptoms in six elderly patients, five of whom revealed clusters of nodules arranged in a circular pattern in the gluteal region presenting a peculiar clinical picture. They were all bedridden and wore cloth diapers. We speculate that wearing a cloth diaper seems to be a major factor behind this condition. Another factor was sitting during the day. A subject had lesions with nodules on the scrotum. The distribution of nodules appeared to be related to the body position and vigorous movement of the patient. In all cases, topical steroid therapies were not effective. They were all positive for bacteriuria. Chronic urinary tract infection further irritates the skin. It is necessary to reduce urine contact and keep the lesion clean.
曾有报道称，尿布接触区域出现簇状结节的婴儿皮肤病为婴儿臀部肉芽肿。最近，此类病症的老年患者数量有所增加，并被报道为老年尿布区肉芽肿。这些病变可能是由粪便和尿液刺激引起的。我们观察到 6 位老年患者出现类似的皮肤症状，其中 5 位患者的臀部区域呈现出簇状结节排列成圆形的特殊临床表现。这些患者均卧床且使用布尿布。我们推测，使用布尿布似乎是导致这种情况的主要因素。另一个因素是白天久坐。有一名患者的阴囊上有结节性病变。结节的分布似乎与患者的体位和剧烈运动有关。在所有病例中，局部类固醇治疗均无效。所有患者的尿液均存在细菌感染。慢性尿路感染进一步刺激皮肤。减少尿液接触并保持病变清洁是必要的。
