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Infantile perineal protrusion: a statistical, clinical, and histopathologic study
R Konta1, I Hashimoto, M Takahashi
1Department of Dermatology, Hirosaki University School of Medicine, Hirosaki, Japan. katsuto@cc.hirosaki-u.ac.jp
Insights
Perineal nodules, a peculiar finding in infants, were studied. These developmental anomalies were exclusively observed in 13% of female infants, appearing as single, midline lesions present since birth.
Area of Science:
- Pediatric Dermatology
- Developmental Biology
- Gynecology
Background:
- Literature review indicated suboptimal analysis of female infant perineal nodules regarding incidence, course, and pathogenesis.
- Previous studies lacked comprehensive data on gender-specific occurrence and lesion characteristics.
Purpose of the Study:
- To analyze the incidence by gender, course, and pathogenesis of peculiar perineal nodules in a large pediatric cohort.
- To characterize the clinical and histopathological features of these perineal lesions.
Main Methods:
- A cohort of 500 children (224 boys, 276 girls, ages newborn to 11 years) was examined for perineal nodules.
- Detailed examination of nodule site, shape, size, number, and onset was performed. Histopathology and clinical course observation were conducted in select cases.
Main Results:
- No perineal nodules were found in boys; 13% of girls presented with these lesions.
- Lesions were consistently single, midline, and peanut-, hen's crest-, or tongue tip-shaped, with 93% present from birth.
- Histological examination revealed redundant skin, not lichen sclerosus et atrophicus.
Conclusions:
- Perineal nodules in infants are a developmental anomaly predominantly affecting girls.
- The findings suggest a distinct etiology for these lesions, differentiating them from other dermatoses.
- Further research into the specific developmental pathway is warranted.
Background:
Review of the literature of the peculiar nodule in the perineum of female infants disclosed that the analysis of incidence by gender, observation of the course, histopathologic assessment, and the pathogenesis of the abnormality was suboptimal.
Objective:
We therefore planned to study a large number of children to analyze the incidence by gender, the course, and the pathogenesis of the peculiar perineal nodules.
Methods:
Of 500 children (224 boys and 276 girls) who ranged from newborn to 11 years of age, occurrence of the perineal nodules was checked. When nodules were found, the site, shape, size, number, and the onset were examined. Histopathologic examination and observation of the course were carried out in some cases.
Results:
None of the boys in our population had nodules, but 13% of the girls did. These lesions always occurred as a single peanut-, hen's crest-, or tongue tip-shaped nodule on the perineal midline, and 93% of the lesions had been present since birth. Histologically, the nodule was an outward projection of essentially normal, redundant skin, showing no evidence of lichen sclerosus et atrophicus.
Conclusion:
In view of these findings, we conclude that perineal nodules are a kind of developmental anomaly occurring mostly in girls.