Successful Treatment of Ulcerative Senile Gluteal Dermatosis by the Concept of Skin Barrier Recovery: A Case Report and Literature Review.

Senile gluteal dermatosis (SGD) is an underrecognized friction- and pressure-related dermatosis predominantly affecting elderly individuals with prolonged sitting and low BMI. It typically presents as hyperkeratotic, lichenified plaques with horizontal ridges within the "sitter's triangle" (the area bounded by the coccygeal apex and the two ischial tuberosities), with or without ulceration. We report the case of a 68-year-old Chinese man with a three-year history of pruritic hyperkeratotic plaques on the left buttock that progressed to superficial ulceration after repeated scratching. Clinical features were characteristic of ulcerative SGD. After gentle debridement of scales and application of a foam dressing aimed at skin barrier restoration, along with pressure off-loading, complete epithelialization occurred within five days, with subsequent fading of residual pigmentation. This case highlights that targeting skin barrier repair could be a potentially effective core strategy for treating SGD.