Chen Hai-Tao, Han Kun, Ma Hui, Li Shuang
Department of Urology, 2. Wuhan Children's Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430016, China.
Department of Plastic Surgery, Wuhan Children's Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430016, China.
Zhonghua Nan Ke Xue. 2022 Sep;28(9):812-816.
To explore the diagnosis and treatment of divided nevus of the penis (DNP) in children.
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.
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.
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.
探讨小儿阴茎分裂痣（DNP）的诊断与治疗方法。
回顾性分析1例采用包皮内板游离皮片移植手术切除治疗的DNP患儿的临床资料，并检索2021年3月以前PubMed、中国知网和万方数据库中的相关文献，分析DNP的临床特点、诊断及治疗方法。
龟头左侧游离皮片成活良好。术后病理显示该DNP为复合性色素痣。患儿随访3个月，期间龟头外观未见明显色差，阴茎功能及感觉无明显异常。从数据库中检索到12项符合纳入标准的研究，报道了36例DNP的临床特征、诊断及治疗情况。多数病变见于6至15岁患儿。术前诊断方法包括皮肤活检、穿刺活检及电子皮肤镜检查，手术治疗方法包括包皮内板游离皮片移植、口腔黏膜游离皮片移植、直接切除缝合、切除后换药及激光治疗。DNP术后病理类型包括皮内痣、混合痣、黑素细胞痣、蓝痣、上皮样黑素细胞瘤及恶性黑色素瘤。所有患者均获成功治疗，预后良好。
小儿阴茎分裂痣是一种少见的色素痣类型。皮肤镜检查可有效提高该病临床诊断的准确性。建议在青春期前对DNP进行手术治疗，包皮内板游离皮片移植是有效的治疗方法之一，具有创伤小、术中及术后出血少、美容效果好等优点。
