Granuloma Gluteale Infantum

Updated: Aug 10, 2017
  • Author: Marlene T Dytoc, MD, PhD, FRCPC; Chief Editor: Dirk M Elston, MD  more...
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Granuloma gluteale infantum (GGI), previously known as vegetating potassium bromide toxic dermatitis or vegetating bromidism, is a rare skin disorder of controversial etiology characterized by oval, reddish purple granulomatous nodules on the gluteal surfaces and the groin areas of infants. Lesions can also be found in intertriginous areas (eg, neck, axilla). The long axis of most lesions runs parallel to the skin lines of cleavage or maximum skin tension.

Photograph of a case of granuloma gluteale infantu Photograph of a case of granuloma gluteale infantum.

A similar eruption may have been described in 1891, and, in 1962, as vegetating bromidism due to the application of bromide ointment. In 1971, Tappeiner and Pfleger, from Germany, first reported 6 cases of granuloma gluteale infantum. [1] In subsequent years, similar episodes were reported in other parts of Europe, Japan, and the United States.

Similar granulomas have been noted in adults confined to bed. These conditions are referred to as granuloma gluteale adultorum and diaper area granuloma of the aged. [2, 3] In contrast to granuloma gluteale infantum, the adult versions are observed only in genitocrural regions and not in intertriginous areas; nodules in the adult versions are often eroded, and they do not show an arrangement parallel to the skin lines.

Photograph of a case of granuloma gluteale adultor Photograph of a case of granuloma gluteale adultorum.

Advances in absorbent diaper technology using synthetic materials have significantly reduced diaper-associated inflammatory skin conditions in recent decades. Also see Pediatrics, Diaper Rash and Diaper Dermatitis.



No systemic association is known.




Granuloma gluteale infantum is rare; only approximately 30 cases have been reported worldwide.


Males have a higher incidence of granuloma gluteale infantum than females.


The condition develops in the diaper area of infants aged 4-9 months.



The lesions persist for 3-6 weeks, followed by spontaneous regression over 2-4 weeks. Residual, brown hyperpigmented macules and lax, atrophic scars are observed in some patients.


Patient Education

Instruct the caregivers of patients to minimize potential contact irritants, which may include cloth or synthetic diapers, paper napkins, plastic pants, and halogenated corticosteroids.

Emphasize to the caregivers of patients the importance of maintaining an intact skin barrier, gently cleansing the diaper area, and protecting the skin from additional trauma.