Granuloma Gluteale Infantum Workup

Updated: May 27, 2021
  • Author: Marlene T Dytoc, MD, PhD, FRCPC; Chief Editor: Dirk M Elston, MD  more...
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Workup

Laboratory Studies

The following investigations may be performed to exclude other entities in the differential diagnoses for granuloma gluteale infantum:

  • Periodic acid-Schiff staining of biopsy specimens to rule out fungi

  • Potassium hydroxide slide mounts and fungal culture of biopsy specimens

  • Fite staining of biopsy specimens for acid-fast bacilli

  • Warthin-Starry stain of biopsy specimens for spirochetes

  • Polarizing microscopy of biopsy specimens for foreign bodies or crystals

  • Rapid plasma reagin test for syphilis

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Procedures

Perform a biopsy of lesions followed by hematoxylin and eosin staining of tissue sections.

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Histologic Findings

Granuloma gluteale infantum exhibits the following histologic characteristics [15] :

  • Parakeratotic stratum corneum

  • Hyperkeratosis and acanthosis of the epidermis

  • 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

  • Absence of foreign body giant cells

  • Dilatation, elongation, and proliferation of dermal blood vessels

  • Extravasation of red blood cells and deposits of hemosiderin

  • No fibrous proliferation, mitosis, or spindle cell formation

  • Presence of starch granules in the lesions

  • Intracytoplasmic structures resembling rickettsialike bodies within dermal macrophages

    Photomicrograph showing the histologic features of Photomicrograph showing the histologic features of a case of granuloma gluteale adultorum. Granuloma gluteale infantum shares identical histologic features (original magnification X100).
    Photomicrograph showing the histologic features of Photomicrograph showing the histologic features of a case of granuloma gluteale adultorum. Granuloma gluteale infantum shares identical histologic features (original magnification X450).
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