Factors involved in the development of diaper-area granuloma of the aged

• Published in: Journal of dermatology Vol. 40; no. 12; pp. 1038 - 1041
• Main Authors: Isogai, Rieko, Yamada, Hidekazu
• Format: Journal Article
• Language: English
• Published: England Blackwell Publishing Ltd 01.12.2013; Wiley; Wiley Subscription Services, Inc
• Subjects: Aged; Aged, 80 and over; diaper-area granuloma; Diapers; Diapers, Adult; Diapers, Adult - adverse effects; excreta-related granuloma; Female; Granuloma; Granuloma - etiology; granuloma gluteale infantum; Humans; Male; nodules arranged in a circle around the anus; paper diaper and cloth diaper; Skin Diseases; Skin Diseases - etiology; diaper-area granuloma; excreta-related granuloma; nodules arranged in a circle around the anus; granuloma gluteale infantum; paper diaper and cloth diaper
• ISSN: 0385-2407; 1346-8138; 1346-8138
• DOI: 10.1111/1346-8138.12337

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.