The clinical differential diagnoses of perianal streptococcal disease are listed in Table 2 . Expected results of diagnostic studies Definitive diagnosis of PSD is made by the growth of a pure culture of group A Streptococcus from a perianal swab. To the best of our knowledge, only a few reports of streptococcal dermatitis secondary to group G exist in the literature Table 1. She stopped the clobetasol ointment. Several cutaneous conditions can affect the umbilicus; several of these can also clinically mimic periumbilical streptococcal dermatitis Table 3 [ 212223 ]. Group G Streptococcus is rarely the infective etiology of perianal streptococcal dermatitis.
Additional concomitant anorectal disease was treated according to standard guidelines.
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Group G Streptococcus is rarely the infective etiology of perianal streptococcal dermatitis. Even with appropriate antibiotic coverage, treatment failures and recurrences are common. Invasive tests, such as culture by needle aspiration or blood tests for anti-streptolysin O antibodies, anti-streptokinase, or anti-streptodornase B titers, are not warranted. Early antibiotic treatment results in dramatic and rapid improvement of streptococcal disease. To the best of our knowledge, only a few reports of streptococcal dermatitis secondary to group G exist in the literature Table 1. We describe a woman with perianal and periumbilical dermatitis secondary to group G Streptococcussummarize the salient features of this condition, and review other cutaneous conditions that clinically mimic streptococcal dermatitis of the umbilicus. Several conditions can mimic the presentation of streptococcal disease.