Relapsing subcutaneous nodules of the penis in a pediatric patient
HTML: 52
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
A 14-year-old boy presented with a history of non-tender, subcutaneous coalescing nodules located on the ventral-lateral aspects of the penis shaft for one year. Laboratory investigations for blood count and autoimmunity were within normal limits. Complete excision was performed, and on histology, the dermis showed necrobiotic material composed of altered collagen bundles, surrounded by a palisade of histiocytes and scattered lymphocytes, thus allowing a diagnosis of subcutaneous granuloma annulare. Only 18 published cases reported penile granuloma annulare. Medical management was advocated in 7/18 cases, either as a first-line or adjuvant therapy where surgery was not radical. Three patients received high-potency local steroids: two cases underwent adjuvant sessions of intralesional triamcinolone, and one patient received pentoxifylline orally. Surgery should be considered a second-line option since 5/8 of treated cases eventually recurred. The pentoxifylline-treated case witnessed a relapse after drug discontinuation, while topical steroids lead to complete recovery without relapses.
Requena L, Fernández-Figueras MT. Subcutaneous granuloma annulare. Semin Cutan Med Surg 2007;26(2):96-9. DOI: https://doi.org/10.1016/j.sder.2007.02.006
Mercieca L, Carabot P, Boffa MJ. Penile Granuloma Annulare. Skinmed 2016;14(3):233-6.
Narouz N, Allan PS, Wade AH. Penile granuloma annulare. Sex Transm Infect 1999;75:186–187. DOI: https://doi.org/10.1136/sti.75.3.186
Sidwell RU, Green JS, Agnew K, et al. Subcutaneous granuloma annulare of the penis in 2 adolescents. J Pediatr Surg 2005;40:1329–1331. DOI: https://doi.org/10.1016/j.jpedsurg.2005.05.023
Forman SB, Sumfest JM, Pride HB, Ferringer TC. Penile granuloma annulare of an adolescent male-case report and review of the literature. Pediatr Dermatol 2008;25:260-262. DOI: https://doi.org/10.1111/j.1525-1470.2008.00647.x
Toepfer NJ, Wessner SR, Elston DM, et al. Three cases of subcutaneous granuloma annulare of the penis: a rare presentation of a common disease. Urology 2011;78(3):508-10. DOI: https://doi.org/10.1016/j.urology.2011.04.031
Floyd MS Jr, Kokai G, McAndrew HF. Granuloma annulare of the penis in a seven-year-old boy. Scand J Urol Nephrol 2011;45:77–79. DOI: https://doi.org/10.3109/00365599.2010.521190
Suarez Peñaranda JM, Aliste C. Granuloma annulare of the penis: an uncommon location for an usual disease. Am J Dermatopathol 2011;33:e44–e46. DOI: https://doi.org/10.1097/DAD.0b013e3181e8b4c3
Kossard S, Collins AG, Wegman A, Hughes MR. Necrobiotic granulomas localised to the penis: a possible variant of subcutaneous granuloma annulare. J Cutan Pathol 1990;17:101–104. DOI: https://doi.org/10.1111/j.1600-0560.1990.tb00064.x
Copyright (c) 2023 the Author(s)
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
PAGEPress has chosen to apply the Creative Commons Attribution NonCommercial 4.0 International License (CC BY-NC 4.0) to all manuscripts to be published.