Recurrent Granuloma Gluteale Infantum Secondary to Encopresis

Background: Granuoma Gluteale Infantum is a rare pediatric dermatological disorder of unknown etiology. Suggested causes have included fluorinated corticosteroids, candida and topical corticosteroids. The case is unique due to its prolonged and recurrent nature, as well as it being secondary to encopresis. The patient is a 3-year-old male that has a history of perianal sores since shortly after birth. The sores persisted for the first three years of life causing significant pain and discomfort. This was most severe during defecation. Pain resulted in avoiding defecation and to encopresis. The patient was referred by their primary care clinician to a pediatric gastroenterologist and was diagnosed with encopresis after an abdominal X-ray. The relationship between the persistent perianal sores and stool pattern was not noted. The patient was referred to dermatology and was treated with barrier creams and laxatives. Results/Conclusions: After initial resolution he returned several months later with a recurrence of the disease. The patient was in joint parental custody and alternated between two different homes. Care-givers were not in agreement with how to manage the patient’s constipation. The sores returned coincident with soiling liquid from liquid stool. The patient was treated again with complete resolution. Our case with its relapsing and remitting course occurring coincident with fecal soiling supports of irritant contact dermatitis as etiology Granuoma Gluteale Infantum.