Histopathological evaluation of the preputium in preschool and primary school boys

To evaluate the dermatopathology of the preputium in preschool and primary school children.

The study group consisted of 32 boys subjected to circumcision procedure for religious belief consecutively between June 2003 and September 2003 in our clinic. The removed foreskin is examined by the same pathologist in all cases and the presence of any dermatopathology was noted.

The mean age of the children was 6+/-2 (4-12) years. Three (9.3%) boys had complete phimosis while 2 (6.2%) had partial phimosis. Among 27 (84.3%) cases without phimosis, the histopathological examination of the preputium revealed focal lichenoid cellular infiltrate with epidermal atrophy in 1 (3.1%) patient. This pattern was considered as early lichen sclerosus et atrophicus (LSA). Minor changes were reported in 1 (3.1%) boy namely minimal inflammation and oedema while 1 (3.1%) patient had more marked oedema and acute inflammatory cell infiltration (diagnosed as balanoposthitis). Three (9.3%) preputium specimens revealed evidence of chronic inflammation. Finally 2 (6.2%) boys showed increased melanin pigmentation in basal segment of the foreskin. In 5 (15.6%) patients with phimosis 1 (20%) (complete phimosis) had chronic inflammation and oedema while the other (20%) (partial phimosis) had chronic inflammatory infiltrate only. The rest of the boys with phimosis had normal preputial pathology. As a total, 22 (68.8%) of the 32 cases had totally normal preputial foreskin.

The presence of foreskin in preschool and primary school children might rarely be associated with important inflammatory dermatoses like LSA even in the absence of phimosis.