Rob Grell, MD
Division of Pediatric Emergency Medicine
Department of Pediatrics
Emory University School of Medicine
7-month-old male with no past medical history presented to the Pediatric Emergency Department (PED) for 4 months of rash and decreased urine output. Mom reports that she had initial sought medical care 4 months ago, but despite treatment and repeated reassurance, the rash has worsened. Over the last 24 hours prior to presentation, the rash became firm, indurated, and more edematous. The rash was initially localized to the diaper region, but recently spread inferiorly to the lower extremities and superiorly to the abdomen. Mom reports failure of treatment with topical steroids and only transient improvement when treated with oral steroids. Working diagnosis at the time of presentation was granuloma gluteale infantum.