Whatever the cause, the course is typically self-limiting and requires no specific treatment. However, they would be unusual in this location, but not unheard of. Hemangiomas are common in infants and young children. However, biopsy is usually not needed.įigure 2.
WHITE PINPOINT RASH ON TEMPLES SKIN
In those subjected to biopsy, the lesions consist of a dense, transdermal granulomatous infiltrate of a variety of cells, and tend to have a linear orientation along skin creases. In some respects, it’s like measles once you have seen a case, you will likely have no trouble recognizing it the next time. This is a visual diagnosis, in that nothing else looks quite like it. Certainly, corn starch remains a popular home remedy for diaper dermatitis, which may explain its presence here, if that’s what those spots were. However, this also has not been a consistent feature. There’s at least one report of lesions containing starch granules, which may explain the tiny white spots seen within the lesions in this case. GGI was originally known as “vegetating potassium bromide toxic dermatitis” because bromide-containing ointments were used for diaper rashes in the “old days.” The predominance of opinion appears to favor the cause nowadays being the overuse of potent topical steroids, whereas others feel the cause may be related to an unusual reaction to Candida infections. In reviewing the literature, one thing is clear: There is no clear underlying cause. A rare condition of unclear etiology, GGI was first reported with a clear description in the early 1970s however, similar cases may date back to the late 19th century. The answer turned out to be C, granuloma gluteale infantum (GGI). The surrounding skin and rest of her exam appeared normal.
There was no discharge noted from any of the lesions, but some evidence of bleeding was apparent in the diaper. Additionally, there was some residue of steroid cream mixed in, and on closer examination, the lesions appeared to have numerous white, pinpoint lesions within each. Examination in the hospital revealed normal vital signs and numerous, raised, dark maroon lesions of various size, in a somewhat linear pattern, covering the entire perineum.Įxamination in the hospital revealed normal vital signs and numerous, raised, dark maroon lesions of various size, in a somewhat linear pattern, covering the entire perineum, as shown in Figure 1.
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