Objective: To explore the diagnosis and treatment of divided nevus of the penis (DNP) in children.
Methods: We retrospectively analyzed the clinical data on a case of DNP treated by surgical resection and transplantation of free skin graft of the inner preputial plate, and searched PubMed, CNKI and Wanfang database prior to March 2021 for relevant literature, followed by analysis of the clinical characteristics, diagnosis and treatment of DNP.
Results: The free skin graft on the left side of the glans survived well. Postoperative pathology showed the DNP to be a complex pigmented nevus. The patient was followed up for 3 months, during which no obvious color difference was observed in the appearance of the glans, and nor evident abnormality in the function and sensation of the penis. A total of 12 studies meeting the inclusion criteria were retrieved from the databases, reporting the clinical features, diagnosis and treatment of 36 cases of DNP. Most of the lesions were found between 6 and 15 years old. Preoperative diagnostic methods included skin biopsy, puncture biopsy, and electronic dermatoscopy, surgical treatments involved transplantation of free skin graft of the inner preputial plate, transplantation of free skin graft of oral mucosa, direct resection and suturing, dressing change after resection, and laser therapy. The postoperative pathological types of DNP included intradermal nevus, mixed nevus, melanocytic nevus, blue nevus, epithelioid melanocytoma, and malignant melanoma. All the patients were successfully treated with excellent prognosis.
Conclusion: Divided nevus of the penis in children is a rare type of pigmented nevus. Dermoscopy can effectively improve the accuracy of clinical diagnosis of the disease. Surgical treatment of DNP before puberty is recommended, and transplantation of free skin graft of the inner prepuce is one of the effective methods for its treatment, with the advantages of minor trauma, less blood loss during and after operation, and good cosmetic effect.
Keywords: children; divided nevus of the penis; dermoscopy; free transplantation.