Laboratory Studies
The following investigations may be performed to exclude other entities in the differential diagnoses for granuloma gluteale infantum:
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Periodic acid-Schiff staining of biopsy specimens to rule out fungi
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Potassium hydroxide slide mounts and fungal culture of biopsy specimens
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Fite staining of biopsy specimens for acid-fast bacilli
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Warthin-Starry stain of biopsy specimens for spirochetes
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Polarizing microscopy of biopsy specimens for foreign bodies or crystals
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Rapid plasma reagin test for syphilis
Procedures
Perform a biopsy of lesions followed by hematoxylin and eosin staining of tissue sections.
Histologic Findings
Granuloma gluteale infantum exhibits the following histologic characteristics [15] :
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Parakeratotic stratum corneum
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Hyperkeratosis and acanthosis of the epidermis
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Dense, superficial, and deep inflammatory infiltrate composed of lymphocytes, histiocytes, plasma cells, and a variable number of focal aggregates of neutrophils and eosinophils forming microabscesses
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Absence of foreign body giant cells
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Dilatation, elongation, and proliferation of dermal blood vessels
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Extravasation of red blood cells and deposits of hemosiderin
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No fibrous proliferation, mitosis, or spindle cell formation
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Presence of starch granules in the lesions
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Intracytoplasmic structures resembling rickettsialike bodies within dermal macrophages
Photomicrograph showing the histologic features of a case of granuloma gluteale adultorum. Granuloma gluteale infantum shares identical histologic features (original magnification X100).
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Photograph of a case of granuloma gluteale infantum.
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Photograph of a case of granuloma gluteale adultorum.
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Photomicrograph showing the histologic features of a case of granuloma gluteale adultorum. Granuloma gluteale infantum shares identical histologic features (original magnification X100).
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Photomicrograph showing the histologic features of a case of granuloma gluteale adultorum. Granuloma gluteale infantum shares identical histologic features (original magnification X450).