Granuloma gluteale adultorum associated with use of topical benzocaine preparations: case report and literature review.
BACKGROUND
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.


OBJECTIVE
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.


CONCLUSIONS
We propose that topical benzocaine preparations may play a role in the pathogenesis of granuloma gluteale adultorum, independent of contact sensitization to benzocaine.
Dytoc
Marlene T
MT
Division of Dermatology and Cutaneous Sciences, University of Alberta, Edmonton, Alberta, Canada.
Fiorillo
Loretta
L
Liao
Janice
J
Krol
Alfons L
AL
D000328:Adult; D000779:Anesthetics, Local / Q000009:adverse effects*; D001566:Benzocaine / Q000009:adverse effects*; D005260:Female; D005836:Genitalia, Female; D006099:Granuloma / Q000139:chemically induced* / Q000473:pathology; D006801:Humans; D012871:Skin Diseases / Q000139:chemically induced* / Q000473:pathology
D000779:Anesthetics, Local; D001566:Benzocaine