Granuloma Inframammary Adultorum

Dermoscopic–pathological correlations in a case of granuloma gluteale adultorum

“…Systemic sclerosis patients with anti-RNAP III antibody develop malignancies more frequently than those without within 3 years before and after the onset of SSc. 3,4 An important point of our case is that anti-RNAP III antibody was not detected by ELISA, but was clearly found by immunoprecipitation. According to a previous study by Kuwana et al, 5 the sensitivity of the ELISA system for anti-RNAP III antibody, in which amino acid residues 891-1020 of RPC155 (the largest subunit of RNAP III) is used, was 91% when 534 sera positive for anti-RNAP III antibody by immunoprecipitation were examined.…”

“…Topical treatments with zinc oxide, calcipotriene or steroids are effective; however, removing the predisposing factors is most important. [1][2][3] Understanding dermoscopic-pathological correlations is especially important and will lead to the correct diagnosis of GGA. The white border corresponds to histopathological findings of peripheral epidermal invagination; the whitish network to the prominent acanthosis; the dotted vessels to the dilated capillaries in the papillary dermis; and the whitish pink…”

Ominous‐appearing papulonodules in the genitocrural area

“…Similar eruptions in adults are variably called 'granuloma gluteale adultorum' or 'diaper area granuloma of the aged', 1 while the rare inframammary counterpart of the disease is labelled 'granuloma inframammary adultorum'. 3 EPD is a multifactorial irritant contact dermatitis presenting as reddish-purple papules and nodules involving the genitocrural region, perianal area and stomal sites. 1,4 Rarely, the inframammary region is involved, 3 while a single case involving the back following skin cancer surgery has been documented.…”

“…The lesions also need to be differentiated from vegetative herpes simplex, condyloma lata, condyloma acuminata, Crohn disease, bacterial or fungal infections, acrodermatitis enteropathica, Langerhans cell histocytosis, lichen planus, halogenoderma, pyoderma vegetans, pemphigus vegetans, metastases and cutaneous lymphomas. [1][2][3][4]6 Skin biopsy shows nonspecific features such as superficial ulceration, varying epidermal changes including spongiotic psoriasiform dermatitis, acanthosis, lichen simplex chronicus-like epidermal hyperplasia, variable density of superficial and deep dermal inflammatory infiltrate, and variable proliferation and dilation of blood vessels. 1,2 Although the histopathology is nonspecific, biopsy is imperative to exclude other diseases.…”

“…The clinical differential diagnoses considered in our case were bowenoid papulosis, extramammary Paget disease and Bowen disease. The lesions also need to be differentiated from vegetative herpes simplex, condyloma lata, condyloma acuminata, Crohn disease, bacterial or fungal infections, acrodermatitis enteropathica, Langerhans cell histocytosis, lichen planus, halogenoderma, pyoderma vegetans, pemphigus vegetans, metastases and cutaneous lymphomas 1–4,6 …”