Infantile gluteal granuloma

　　First, etiology

　　The etiology of this disease is not yet clear. The following views are some of the opinions:

　　1. The incidence of viral infection is high among people in close contact with the patient, and Lerine et al. proposed that the titer of EB virus antibodies in the patient's serum is increased, suggesting a relationship with EB virus infection, but there is no conclusive evidence.

　　2. The patient has a history of long-term topical treatment with fluorinated corticosteroids for diaper rash, and the skin lesions can gradually and slowly regress after stopping treatment.

　　3. It may be related to other types of ML, multiple idiopathic hemorrhagic sarcomas, or leukemia;

　　4. Cellular immune deficiency: According to the decrease of T lymphocytes in the patient's blood, low cellular immunity, disappearance of normal delayed-type hypersensitivity, slow rejection of allogeneic transplantation, and early lesions often starting from the T zone of the lymph nodes, it is believed that this is due to the defect in the immune surveillance function of T cells, leading to abnormal neoplastic hyperplasia of 'reticular cells'.

　　Second, pathogenesis

　　The pathogenesis is not yet clear. Due to the controversy over the origin of R-S cells, further discussion is needed. Regarding the origin of R-S cells, there are views that they come from T lymphocytes, B lymphocytes, histiocytes, or interdigitating reticular cells or dendritic reticular cells, etc. Currently, most people tend to believe they come from reticular cells, but this has not been confirmed.

　　Common complications of this disease include:

　　1. Recurrent infections:Local skin lesions can lead to recurrent bacterial and viral infections, causing lymphangitis, lymphadenitis, and other conditions.

　　2, Accompanied by chronic diarrhea:Allergic problems such as rhinitis.

　　3, Due to chronic diarrhea:Affecting the absorption of nutrients, causing delayed development, stunted growth, and other symptoms in children.

　　4, Repeated infection leading to lymphangitis:Causing local edema, scars, etc., and in a very few cases, skin malignancy due to ulceration, scars, and inflammation.

　　Infant hip granuloma often manifests as smooth, elevated, light red-blue nodules, round or oval, several millimeters to several centimeters in diameter, irregularly distributed in the areas covered by diapers, without自觉 symptoms.

　　The etiology is not very clear at present, so there is a lack of effective preventive measures. Mainly pay attention to the following points:

　　1, Avoid:Local eczema, avoid long-term use of hormone-based drugs.

　　2, Avoid:Marriage between close relatives, pregnant women with family history, can be given early intervention. It is recommended to do prenatal examination.

　　3, Strengthen Nursing:and nutrition to enhance the child's resistance and immunity.

　　4, Prevention:Infection should be isolated, and contact with the pathogen should be minimized as much as possible.

　　Histopathology: Hyperkeratosis of the epidermis and hyperplasia of the stratum spinosum, dense polymorphic inflammatory infiltration in the dermis visible, including mononuclear cells, neutrophils, and eosinophils. In addition, there is extravasation of red blood cells, hyperplasia of capillaries, and small abscesses composed of neutrophils and eosinophils.

　　Infants have no special dietary requirements; mainly normal feeding with attention to nutrition, reasonable feeding. Breastfeeding should be practiced as much as possible during infancy. It is necessary to strengthen the mother's nutritional supply and maintain her physical health. For children who cannot be breastfed, choose suitable formula milk in a timely and correct manner for regular formula milk feeding. As children grow older, timely supplementary food should be added to avoid anemia, malnutrition, vitamin, and mineral deficiencies.