Should I be worried?A duplicated or bifurcated gluteal fold was the most frequent cutaneous manifestation as observed in 31 (46%) infants and gluteal asymmetry in 11 (16%; Table 1 and Figure 1). 04%, they are. This is the American ICD-10-CM version of M21. This is the American ICD-10-CM version of M21. 072 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. 1 The latter name, although. 6 days). The 2024 edition of ICD-10-CM M21. Start studying SDL 3 & 4 CNS Malformations. About 1 in every 1,700 babies is born with cleft palate in the United States. Pilonidal disease begins as loose body hairs get caught in these pores and find. The patient is intubated on a sterile draw. Deep gluteal syndrome (DGS) is an underdiagnosed entity characterized by pain and/or dysesthesias in the buttock area, hip or posterior thigh and/or radicular pain due to a non-discogenic sciatic nerve entrapment in the subgluteal space. Cranial defects include anencephaly, exencephaly, and encephalocele. My pediatrician said my son has a bifurcated gluteal cleft. The buttocks can be the most susceptible place boils for two reasons. I think getting the ultrasound is a great idea because we do want to see if there is an issue with the lower part of the spinal cord. The authors gathered clinical illustrations of gluteal cleft wounds and conducted a literature search as a basis for presentation to conference attendees, with the goal of gaining consensus regarding guidelines for accurate classification of these wounds. As the tittle says I am currently waiting on a back scan for my little man hes 14 weeks old hes got a y shaped gluteal cleft, it feels dead boney where this is. If the base could not be seen, this would be called a coccygeal pit. Midline pore or pit: in the center of the gluteal crease, normal skin pores can become enlarged. The average Roman aristocrat consumed up to 250μg of lead daily. 8±42. ICD-9-CM 757. Urinary tract issues (which include trouble emptying their bladder and frequent urinary tract infections. 7 may differ. A pilonidal cyst may not cause symptoms. 5 cm above the anus or proximate to the coccyx, and deviated gluteal. flat hemangioma, non-midline lesion, forked gluteal cleft, coccygeal pit, simple sacral dimple, and asymmetric cleft are. 622 became effective on October 1, 2023. Psoriasis can also affect other genital tissue, including the penis, vulva. The diffuse surrounding enhancement (arrowhead) indicates superimposed infection. 622 - other international versions of ICD-10 M21. Pediatr Rev. Stan L. The gluteal region is then prepped and draped in standard sterile fashion. Approximate Synonyms. Gluteal Muscles. The patient was born at 40 weeks and 1 day of gestation to a 21-year-old gravida 2 now para 2 mother by vaginal delivery. The child’s Weprin and Oakes5 conducted a thor- the authors examined the records of condition will need to be confirmed by ough English language literature search 1,000 patients — mostly younger than MRI and repaired after age 8 months per of cutaneous coccygeal abnormalities. 5 cm from the anus. Distinctive skin lesions of SGD are brownish scaly plaques on the gluteal cleft and both sides of the buttocks assuming a pattern of “three corners of triangle” (Fig. M21. 39 is a billable medical code that can be used to indicate a diagnosis on a reimbursement claim, however, 757. Download MyChart to connect with your care team. Pressure injuries, however, are ischemic injuries to the skin and underlying soft tissue that can result in full-thickness tissue damage. Deep natal cleft is an important factor in the pathogenesis of pilonidal sinus disease [ 14 ]. 96. (B) Sever all knee ligaments. More than 50% of OSDs are diagnosed when a dimple is noted, but obviously not all dimples are associated with an OSD. A total of 34 (24%) patients had an abnormal spinal ultrasound; 15 (44%) of these infants underwent a lumbar magnetic resonance imaging. With thousands of award-winning articles and community groups, you can track your. there is a duplicated gluteal cleft; there is more than one dimple; the dimple lies outside the sacrococcygeal region; there are any neurological abnormalities noted; The above may be associated with an underlying neurological problem, for example spinal dysraphism. 9 - other international versions of ICD-10 P13. Subcutaneous lipomas. We cut down about 2-3 cm through. Cleft foot is a rare congenital (meaning your baby was born with it) anomaly in which the foot didn’t develop properly during fetal development. Sacral epidermal anomalies include dimples, tracts, lipomas, hemangiomas, and tufts of hair and may be associated with a neural tube defect, such as spina bifida. Messages 2,335 Location E. This is the American ICD-10-CM version of M67. SGD presents in. The upper part of the neural tube forms the forebrain, midbrain and hindbrain. Spina Bifida Occulta (Occult Spinal Dysraphism) Spina bifida occulta is a common anomaly consisting of a midline defect of the vertebral bodies without protrusion of the spinal cord or meninges. Atypical dimples may be located higher up on the back or off to the side. 9). Block, MD, FAAP, is Professor of Clinical Pediatrics, University of Louisville, and University of Kentucky, Lexington, KY; President, Kentucky Pediatric and. Use Additional. Results: Most patients were white (91. 0):. The authors gathered clinical illustrations of gluteal cleft wounds and conducted a literature search as a basis for presentation to conference attendees, with the goal of gaining consensus. 95. The authors gathered clinical illustrations of gluteal cleft wounds and conducted a literature search as a basis for presentation to conference attendees, with the goal of gaining consensus regarding guidelines for accurate classification of these wounds. Pilonidal literally means a “nest of hair. After injecting with 0. With a perineal fistula, the abnormal anal opening is located outside of the sphincter muscle complex, such that the fistula usually has very few voluntary sphincter muscle fibers surrounding it. The ICD code L05 is used to code Pilonidal cyst. She previously was diagnosed by her periodontist with erosive lichen planus and was prescribed topical and oral steroids with minimal improvement. 419 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. Pilonidal sinus disease is a disease of the inter-gluteal region *, characterised by the formation of a sinus in the cleft of the buttocks. Y shaped gluteal waiting for scan. On palpation this is noted to be over the right iliac posterior superior iliac spine. Has anyone had any expierence with this ?Answer: Gluteal cleft. Pilonidal disease is a potentially debilitating condition affecting ~70,000 patients annually in the United States alone. 11 Itch is more typical of dermatitis and tinea than of psoriasis, but this is not universal. 1-1). 5. We discuss the clinical presentation and the histopathological findings and review the literature. The. Cleft foot is very rare, affecting fewer than 1 in 1,000,000 babies. Male/8. 4,16,18,19 A simple sacral dimple is located in the midline, within the gluteal cleft, has a diameter less than 5 mm, and is less than 2. Figure 1. Chiari malformation (a condition in which brain tissue extends into the spinal canal, or top of the spinal cord) Hydrocephalus (a build-up of fluid in the ventricles, or cavities, in the brain. In cases of isolated bifid uvula, and in cases of submucous cleft palate without hypernasality, no surgical intervention is needed. The affected areas were examined with a Wood's. Present On Admission. This is the American ICD-10-CM version of Q82. 31-year-old male with history of human immunodeficiency virus (HIV) presented with complaints of pain and redness to the right inner buttock; vital signs were within normal limits. Download the BabyCentre app Opens a new window. A pilonidal cyst, also referred to as a pilonidal abscess, pilonidal sinus or sacrococcygeal fistula, is a cyst or abscess near or on the natal cleft of the buttocks that often contains hair and skin debris. gluteal cleft / natal cleft / cluneal cleft / butt crack) is the posterior deep midline groove in the gluteal region. Two pilonidal cysts that have formed in the gluteal cleft of an adult man. 9 became effective on October 1, 2023. I discovered a hard, painfu massl on my gluteal cleft area. 419 may differ. It is decorated from the upper side with rhinestones and colorful studs. The gluteal cleft is never exposed. 0 became effective on October 1, 2023. mbort True Blue. k. It covers the area from iliac crest from above to the gluteal fold below. Poisoning by, adverse effect of and underdosing of drugs, medicaments and biological substances. A review of 5 cases described a characteristic clinical presentation of a butterfly-shaped bilateral gluteal cleft lesion on most patients. But if it's infected, the skin around the cyst may be swollen and painful. 061 may differ. For claims with a date of service on or after October 1, 2015, use an equivalent ICD-10-CM code (or codes). The gluteal fold is the crease formed by the inferior aspect of the buttocks and the posterior upper thigh. code for adverse effect, if applicable, to identify drug ( T36-T50. ICD 10 code for Other congenital malformations of spine, not associated with scoliosis. Morphology. kdmahnke13. The depth of gluteal cleft varies and depend upon the developed gluteal muscles. 2 × 1. 96. These four muscles fill the gluteal (buttock) region and provide it with shape and form. The gluteal cleft most of the time heals on its own but if not, then a proper treatment along with a pain reliever is recommended. S. Thirty-one infants with a sacral dimple had an echogenic filum terminale, and 57 children had a filar cyst. The term pilonidal cyst comes from the Latin words, “pilus” (hair) and “nidus” (nest). The 2024 edition of ICD-10-CM Q82. Despite its potential importance in anthropological [] or even forensic [3,5] studies, no detailed data on variation in the degree of spinous process bifurcation can be found in the published literature. Expand all. Surgical revisions to correct a secondary cleft lip deformity may be safely performed during the same anesthetic procedure through the growing age (postpalatoplasty fistula repair, intermediate cleft rhinoplasty, velopharyngeal insufficiency surgery, or secondary alveolar bone grafting) or at skeletal maturity (after orthognathic surgery, when it is indicated; and definitive surgical. Nail psoriasis, psoriatic lesions in the gluteal cleft and on the scalp usually accompany PsA, especially in adult men [5, 6]. The internal iliac artery arises where the common iliac artery bifurcates into internal and external iliac arteries; it then crosses the pelvic brim to. DX? dmaec True Blue. My pediatrician said my son has a bifurcated gluteal cleft. bilaterally over the gluteal cleft. This causes the affected foot to have missing toes, a V-shaped cleft, and other anatomical differences. Symptoms are usually minimal, but mild to severe itching may occur. The Washington Board of Massage revised the Washington Administrative Code in August 2020. My pediatrician said my son has a bifurcated gluteal cleft and ordered an ultrasound for his spine. Open the PDF for in another window. Should I be worried?My pediatrician said my son has a bifurcated gluteal cleft. Ultrasound is valuable for imaging of infants and young children and for. Case reports of median tongue clefts in the literature show mostly a combination with a cleft of the median lower. Results: The most common lumbosacral cutaneous manifestations were bifurcated/duplicated gluteal folds (33%), gluteal asymmetry (19%), and sacral dimples (14%). However, imaging. The most common lumbosacral cutaneous manifestations were bifurcated/duplicated gluteal folds (33%), gluteal asymmetry (19%), and sacral dimples (14%). . 8 × 2. Sex hormones act on sudoriferous glands and affect hair growth; other factors like sitting for. Cluster of abscesses under the surface of the skin; transient with random distribution; usually triggered by an infection. 072 became effective on October 1, 2023. About 1 in every 2,800 babies is born with cleft lip without cleft palate in the United States. A recent meta-analysis of 6,143 studies by Stauffer et al. These cysts are usually caused by a skin infection and they often. The devastation of recurrence with further pain, embarrassment, and time off work or school (in some cases for months or years), plus the prospect of more surgery is still common for patients with postanal pilonidal sinus. 1 Given the low incidence rate of OSD at 0. Feb 4, 2023 at 3:55 PM. Our case cannot be put in any well-defined syndrome. 5 cm area of induration, fluctuance, erythema, and tenderness to the right buttock along the gluteal cleft. If too much fat it can be repaired by liposuction and fat transfer to the gluteal dimple. 29: Hypospadias: Gluteal asymmetry: CM ends at L2-3: N/A: No clinical TCS: Female. 821 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. A pilonidal cyst (also called pilonidal cyst disease, intergluteal pilonidal disease or pilonidal sinus) is a skin condition that happens in the crease of the buttocks — anywhere from the tailbone to the anus. 821A is grouped within Diagnostic Related Group(s) (MS-DRG v 41. We report a new rare case of a 67-year-old man affected by an intergluteal cleft EPC, with inguinal and lung metastasis. A Caucasian female neonate with abnormal gluteal cleft had ventriculus terminalis cyst with an extra-axial cyst at the conus–filar junction and taut lipomatous filum on ultrasound examination and magnetic resonance imaging. 0±8. 1 The latter name, although. [2–4] These syndromes are all associated with median lip and/or mandibular clefts and digital variations. The information contained in this handout should not be used as a substitute for the medical care and advice of your pediatrician. z. The aim of this article was to summarize results of the consensus sessions that occurred. . gluteal cleft with associated midline pits. It is designed by a fashion designer named Kimberly brewer. The 2024 edition of ICD-10-CM S31. 1,2 The associ-ated flow chart outlines the decision-making and man-agement of the disease. “High-risk” dimples are defined as those that are (1) deep; (2) larger than 0. gluteal cleft / natal cleft / cluneal cleft / butt crack) is the posterior deep midline groove in the gluteal region. The gluteal cleft shield is directly applied on the skin and fixes itself above the waistband. subcutaneous masses(M)withextension intoglutealmuscles. split; divided; a crack or crevice; an indentation between two parts, as of the chin Not to be confused with: clef –. or feet but are often found on or around the natal cleft. 53%) and the upper part of. Epigastric mass; Epigastric swelling, mass. The 2024 edition of ICD-10-CM M26. BACKGROUND AND INCIDENCE. Pain of the front of the thigh is likely to be due to a problem with the compression of the nerves of the thigh, either the Femoral nerve or upper lumbar nerve root. Oct 16, 2008 #3 Here, this link may help you. Objective: To evaluate hidradenitis surgical patients. Code First. Pilonidal cysts can range from abscesses — painful collections of pus — to sinuses, and lead to persistent bloody drainage. gluteal cleft. Radiation Oncology Attendi. 5. Benign features: single midline dimple in sacrococcygeal region visible intact base <2. The causes of orofacial clefts among most infants are unknown. A cleft lip is a birth defect that results in a unilateral or bilateral opening in the upper lip between the mouth and the nose. Urinary tract issues (which include trouble emptying their bladder and frequent urinary tract infections. Alterations in muscle signal intensity seen in pathologic conditions usually fall into one of. (170 g) 12 Triad applied directly to the wound Triad impregnated into gauze Facilitating autolytic debridement 1. generally speaking, scoliosis can cause asymmetry of back and buttocks. MANAGEMENT The first step in managing pilonidal disease is delineating an acute episode of inflammation from chronic and recur-rent disease (see Evaluation and Treatment Algorithm). There are several disorders that can. 061 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. They are caused by interaction of genetic and environmental factors, and are prevented with folate supplementation. Sacral Dimples and Pits: When to Worry. View article titled, Lumbosacral Nevus Simplex in a Newborn Girl with an Asymmetrical Y-Shaped Gluteal Cleft. com. not so much: Pilonidal "dimples" are properly called "pits", are always in the midline in the gluteal cleft, and are where infection of the pilonidal cyst starts, as dislodged hairs can work themselves into these. Sometimes referred to as the sacrococcygeal area, the intergluteal cleft is the fissureA submucous cleft palate is an opening in the tissue covering the soft palate in your mouth. Has anyone had any expierence with this ? Thanks x. 1 Historically, the concept of MASD arose from recognition that many skin lesions identified. not associated with other cutaneous stigmata of spinal dysraphism (e. • Suitable for use on neonates1. Usually asymptomatic; affects the head, neck, back, or. Of the 107 non-Hispanic whites who had perianal nevi, 1 or more nevi were detected in the anal margin in 21. Medially, the region extends to the mid-dorsal line and is called the intergluteal cleft, which is the groove that separates the buttocks from each other. Our content is doctor approved and evidence based, and our community is moderated, lively, and welcoming. 39 should only be used for claims with a date of service on or before September 30, 2015. We were unable to identify any associated orofacial abnormalities, genetic predisposition, tongue piercing or history of postnatal trauma. For many, a split bum crack (also known as intergluteal cleft) can be both painful and embarrassing. Rarely, they can be indicative of underlying spinal defects. 0%. The 2024 edition of ICD-10-CM Q36. Remove femur after distal mobilization and disarticulate hip posteriorly through the decubitus ulcer. After injecting with 0. Note the double ‘equals sign’ and the changing distance between both parts showing the cleft uvula. Gluteal Deadlifts. The differential diagnosis included intertrigo, erythrasma, seborrheic dermatitis, inverse psoriasis, and resistant Candida secondary to poorly controlled diabetes. Gluteal cleft shield is a cover which is used to avoid problems related to gluteal cleft. b. While the diagnosis of acquired GF relies primarily on clinical findings, poliomyelitis and other diseases, cerebral palsy, and neuromuscular disorders. 4. buttocks The intergluteal cleft or just gluteal cleft, also known by a number of synonyms, including natal cleft, butt crack, and cluneal cleft, is the groove between the buttocks that runs from just below the sacrum to the perineum, so named because it forms the visible border between the external rounded protrusions of the. Pilonidal disease is an infection under the skin in the gluteal cleft. The most common neural tube defects include anencephaly, which affects brain and skull development and is incompatible with. 9 may differ. Background Pilonidal disease classically presents as an abscess or soft tissue swelling which classically occurs in the intergluteal cleft, just above the anus. 04%, they are likely too common to be considered high risk. A 63-year-old male with a 20-year history of a chronic, recurrent sacrococcygeal pilonidal cyst was referred to our outpatient clinic. - Answered by a verified Doctor. 7 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. Neural tube defects are congenital anomalies of neural development with a spectrum of clinical manifestations; they can affect the cranium or spine. In the patient's gluteal cleft, about 3 cm away toward the coccyx, there was a perineal wound. 2 In 2004, there were 2604 cases of pilonidal cysts reported in U. A person with a pilonidal cyst may experience swelling, pain, and skin discoloration in the affected. George Karydakis in 1973. split in 2 distinct components with one dorsally and one inferiorly going between a bifurcated sciatic. This muscle group consists of the gluteus maximus, gluteus medius, gluteus minimus and tensor fasciae latae. 1 Anal cancers progress slowly and are commonly mistaken for benign processes such as hemorrhoids. John Bascom in 1987. supplies: 1. Epidemiology. My boyfriend has an ulcer (looks like a bedsore) along one side of his gluteal fold. The area of tissue between the anus and the scrotum in boys, and between the anus and posterior fourchette, in girls. Presentation and Diagnosis. 7 became effective on October 1, 2023. The cleft lift procedure was described by Dr. The literature reports median tongue clefts only to be associated with orofacial digital syndromes type I, II, IV and VI. The patient is able to sit, has full pelvic range of motion, and sexual intercourse. 9. The rules are now final and are effective September 1, 2021. Linear lesions in the intergluteal cleft are caused by moisture with or without a friction component and should be classified as intertriginous (between skin folds) dermatitis. Postoperative deformities were classified as cleft unchanged (grade 1), moderate cleft lengthening (grade 2), or severe cleft. 3 Abscess for-mation is a possible result of pilonidal cyst infection. In very mild cases, such as isolated. 6). Being sun. The patient has an unusual sacral crease and sacral dimple. It extends from sacral level S3 or S4 and ends just inferior to the apex of the sacrum, at the level of the anus. Referred pain from TrP1 can cover the sacroiliac joint, the gluteal cleft and continue over the ischial tuberosity. These tests may include: Ultrasound. 2 is grouped within Diagnostic Related Group (s) (MS-DRG v41. Outlook. Cute vs. Multiple factors contribute, including genetics. Access records and results, view and pay bills, request prescription renewals, and request appointments. 5% (47 of 219), gluteal cleft in 36. T86. • Suitable for use on neonates1. The neural tube is the structure in a developing embryo that eventually becomes the baby's brain, spinal cord and the tissues that enclose them. Sometimes a Pilonidal contains hair and sometimes not. Cluster of abscesses under the surface of the skin; transient with random distribution; usually triggered by an infection. Dr. 829A - other international versions of ICD-10 S31. The fat was injected with a 4 mm angled basket cannula attached to a power-assisted handpiece (Microaire Surgical. 8 became effective on. Coccygeal dimples, increased lumbosacral and/or coccygeal hair, deviations and/or duplications of the gluteal crease, and lumbosacral slate-grey patches are. The coccygeal region has complex anatomy, much of which may contribute to or be the cause of coccyx region pain (coccydynia). Should I be worried?the right of the gluteal cleft. Inflamed, swollen skin. Epidermoid cyst. Design Before-and-after trial. Sacral dimples are very common—they’re present in 2-4% of newborns overall! Almost all neurosurgical referrals for suspected OSD in children <1yo are for evaluation of a dimple. Several sites can be affected including the axillae, under the breasts, umbilicus, groins, gluteal cleft (between the buttocks), around the anus, penis / scrotum and the vulva. read more. ICD-10-CM Q18. A new paradigm suggests that a procedure to change the shape of the gluteal cleft will improve results. mbort True Blue. 821A. Background The Cleft-Lift procedure for pilonidal disease, is a procedure that addresses the presence of a deep gluteal cleft as the etiology of the disease. The patient has an unusual sacral crease and sacral dimple. 5 cm from the anal. 419 became effective on October 1, 2023. 061 became effective on October 1, 2023. My pediatrician said my son has a bifurcated gluteal cleft. Indications for imaging included isolated dimple in 235 patients (45%), asymmetrically deviated. 6% (in Turkey). Oozing of the skin with serous drainage and/or secondary infec-tion would suggest dermatitis over psoriasis. The intergluteal cleft (a. Background: Hidradenitis suppurativa is a progressive, recurrent inflammatory disease. If you are considering a surgery, I would suggest you to consult a board-certified plastic surgeon. Medially, it is separated by an intergluteal cleft, while laterally, it is bordered by the hip region. 821 became effective on October 1, 2023. The patient’s. The gluteal cleft is the groove running between each buttock, from the base of the spine to the perineum, which is the area between the anus and genitals. Messages 2,335 Location ENGLEWOOD/DENVER Best answers 0. Describe the difference between male and female pelvis. A lump of. Choices for etiologic factors were pressure, moisture, incontinence-associated dermatitisThe gluteal region is located at the back of the body, representing the transition point between the trunk and the lower limbs. Most patients are asymptomatic and lack neurologic signs, and the condition is usually of no consequence. Applicable To. Posted 18-03-18. Colloquially the intergluteal cleft is known as bum crack(UK) or butt crack(US). Incontinence-associated dermatitis (IAD) is a common and under-recognized painful skin condition, caused by erosion of the skin from chronic exposure to urine, stool, or both, from incontinence []. 5 × 1. M26. Triad Hydrophilic Wound Dressing Product Code Size Units 1964 2. The hip joint is the most stable joint in the body and is supported by a very strong capsule and several. Coccydynia is a common condition that is known to be difficult to evaluate and treat. Messages 1,130 Location Hibbing, MN Best answers 0. Nine patients had 2 LsCMs suggestive of OSD; specifically, gluteal asymmetry and a coccygeal pit (2 infants); lumbar hair and coc-Intertriginous skin, also known as skin folds, are sites in which opposing skin surfaces come into contact while at rest, resulting in chronic skin occlusion. 6 became effective on October 1, 2023. It occurs in the perineum, labial folds, groin, upper thighs, buttocks, rectal area and gluteal cleft, as well as areas where there is increased friction between skin and clothing, or between skin and absorptive devices 3, 4. A pilonidal cyst typically is diagnosed. It is the most common site of intra. To the best of our knowledge, no cases of intergluteal cleft EPC have been reported in the English-language literature to date. Two main varieties of duplicated gluteal creases were identified: Y-shaped and pitchfork-like. (e. It separates the two glutes (and the buttocks) from each other and extends downwards from the third or the fourth sacral spine, deepening as it goes inferiorly. The superior tip of the intergluteal. A sacral dimple can be a sign of a serious spinal problem in a newborn if the dimple is large or appears near a tuft. Pilonidal cysts tend to occur on a person’s lower back, just above the cleft of the buttocks. The gluteal cleft is the area of separation between the two buttocks. Psoriasis is an inflammatory disease that manifests most commonly as well-circumscribed, erythematous papules and plaques covered with silvery scales. Skin lesions and Associations (duplicate gluteal cleft, asymmetrical intergluteal crease, skin tag, tail. Gluteal tendinopathy is a common cause of hip pain, especially in older women. (Photo contributor: Louis La Vopa, MD. 7 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. The authors gathered clinical illustrations of gluteal cleft wounds and conducted a literature search as a basis for presentation to conference attendees, with the goal of gaining consensus regarding guidelines for accurate classification of these wounds. CONCLUSION. Grasp the folded edge of the main drape and the bottom edge of the hand towel or. Linear lesions in the intergluteal cleft are caused by moisture with or without a friction component and should be classified as intertriginous (between skin folds) dermatitis (inflammation of the skin). Gluteal cleft Shield Gluteal cleft shield is a cover which is used to avoid problems related to gluteal cleft. Sciatic nerve, inferior gluteal vessels, and posterior femoral cutaneous nerve (arrow) arebetweengluteusmaximusmuscle(MX)and quadratus femorismuscle(QF). Diaper Area, Buttocks, and Gluteal Cleft OVERVIEW The unique environment of the diaper area is predisposed to the friction of repeated movement, chafing, local heat, and maceration from retained moisture, all of which serve to provide an excellent environment for potential irritant, fungal, as well as bacterial complications. The skin in my gluteal cleft ( right at top of bum crack) keeps splitting, off and on for the last 18 months and it's very painful. Congenital hip dislocation and bilateral club feet in an infant with Poland's anomaly.