Infantile Acropustulosis and Granuloma Gluteale Infantum

Abstract

INFANTILE ACROPUSTULOSIS In 1979, two reports, published simultaneously in the Archives of Dermatology, described a new cutaneous disorder, infantile acropustulosis.1,2 The authors of these papers indicated that patients with this eruption had been discussed at national dermatology meetings as early as 1976, although no studies had previously been documented in the literature. Both the presentations at meetings and the written descriptions evoked instant recognition of this entity by pediatric dermatologists, many of whom recalled the frustration of caring for such an infant whose eruption defied diagnosis and effective management. Clinical Findings Infantile acropustulosis is truly a disorder of infancy with onset usually between 2 and 10 months of age. However, both Kahn and Rywlin1 and Lucky and McGuire3 described infants purported to have lesions at birth. Despite the paucity of reported cases of infantile acropustulosis, the collected experience has suggested that black males have a predisposition for this eruption, although affected infants of both sexes and all races have been identified. The lesions of this disorder are quite characteristic, demonstrating a rapid sequence of morphologic changes as they evolve. Early lesions are discrete, 1- to 2-mm erythematous papules, which became vesiculopustular within 24 hours (Fig 1, top left) and subsequently crust prior to healing.