PURPOSE: We evaluated the effect of a topical steroid(0.05% clobetasol propionate[Dermovate(R)]) on phimosis. MATERIALS AND METHODS: Between May 2005 and May 2007, 30 boys with phimosis were assigned to receive topical application of Dermovate(R). Of the 30 boys, 19 boys had concealed penises. The parents of the boys were instructed to retract the foreskin gently without causing pain, and to apply the topical steroid over the stenotic opening of the prepuce twice daily for 4 weeks then for another 4 weeks if no improvement was achieved. Retractibility of the prepuce was graded from 1-6. Response to treatment was arbitrarily defined as improvement in the retractibility score(complete response, score 5 and 6; partial response, score 3 and 4; no response, score 1 and 2). The effect of treatment was studied with respect to the duration of treatment, age, and an associated concealed penis. RESULTS: The pretreatment grade in all patients was a retractibility score of 1. The mean age of the patients was 48.5+/-27.6 months(range, 7-108 months). The complete response rates in boys treated for 4 and 8 weeks were 50% and 73.3%, respectively. In boys younger than 3 years of age (n=12) and older than 3 years of age(n=18), the complete response rates were 75% and 72.2%, respectively(p=0.866). In boys with or without an associated concealed penis(n=19 and n=11, respectively), the complete response rates were 63.1% and 90.9%, respectively(p=0.199). No adverse effect was encountered in all patients. CONCLUSIONS: Our data suggest that the application of topical steroids for 8 weeks as a first line treatment of phimosis may be effective, although further studies are needed to establish the definite efficacy and safety of this procedure.
Child ; Clobetasol ; Female ; Foreskin ; Humans ; Male ; Parents ; Penis ; Phimosis ; Steroids

Vitiligo is an acquired systemic disease of the skin characterized by circumscribed patches of complete pigment loss due to destruction of melanocytes. A 28-year old male patient presented with generalized depigmented patchs. We performed microscopic studies of cultured melanocytes from this patient and compared them with those of normal neonatal foreskin. Phase contrast microscopic findings revealed no difference between the two groups of melanocytes, but transmission electron microscopic findings showed dilated circular rough endoplasmic reticulum in cultured melanocytes from our vitiligo patient. We could observe the innate cellular structural aberration of melanocytes from the vitiligo subject.
Adult ; Endoplasmic Reticulum, Rough ; Foreskin ; Humans* ; Male ; Melanocytes* ; Skin ; Vitiligo*

In the repair of hypospadia, the use of bladder mucosal grafts in cases in which previous adequate foreskin for urethral reconstruction is lacking or in which previous repairs have failed, is feasible. The bladder mucosal graft offers several theoretical advantages. It is of the same histologic character as the normal urethra, is not hair bearing, tends to re-epithelialize exposed surfaces and has great dispensability. We have experienced two cases of the perineal and penoscrotal hypospadias repaired successfully by the bladder mucosal graft technique.
Female ; Foreskin ; Hair ; Hypospadias* ; Male ; Transplants* ; Urethra ; Urinary Bladder*

PURPOSE: Phimosis is the inability to retract the foreskin of the penis over the glans of the penis. Even though phimosis is not pathogenic, the presence of phimosis is known to increase the risk of urinary tract infection in infancy. The use of topical steroids has been advocated as a safe and economical alternative to surgical intervention. The purpose of the study was to assess the effectiveness of topical steroids for the treatment of phimosis in young boys. METHODS: A total of 53 boys with phimosis were divided into two groups to distinguish between the efficacy of low-potency topical steroid (group 1, 27 cases) and of high-potency topical steroid (group 2, 26 cases). RESULTS: The success rate increased in the process of time. After 6 weeks, the success rate was 21 cases in group 1 and 22 cases in group 2. There was no significant differences in treatment outcomes between the two groups. The age of the boys, the appearance of prepuce prior to treatment, and the presence of previous symptoms, including symptoms of UTI, and ballooning of the prepuce at micturation had no significant difference on treatment outcomes. CONCLUSION: Topical steroid was effective in treatment of phimosis in boys younger than 4 years old. Although treatment outcomes between low- and high-potency topical steroids were not significantly different, those treated with a high-potency steroid cream showed more fast improvement. Further studies are necessary to assess systemic side effects of steroid treatment, duration of treatment and prevention of genitourinary tract infection in male infants.
Child, Preschool ; Female ; Foreskin ; Humans ; Infant ; Male ; Penis ; Phimosis* ; Steroids ; Urinary Tract Infections

The cutaneous synthesis of vitamin D in response to ultraviolet radiation exposure is the most important factor in maintaining vitamin D balance in Man. The skin is not only the site of vitamin D synthesis, but also a target organ for calcitriol(1, 25-dihydroxy-vitamin D) which is naturally occuriag, hormonally active form of vitamin E. It is now known that calcitriol inhibits the proliferation of epidermal cells and induces her differentiation. In this study, epidermal keratinocytes and melanocytes were isilated from the neonatal foreskin, and were culturod using a MCDB 153 and modified TIC media, respectively. And then various concentratioris of calcipotriol(MC 903), a synthetic aralogue of calcitriol, were added to each culture. The effects of calcipotriol on the growth of human keratinocytes and melanocytes were investigated. The results were as follows : 1. The addition of calopotriol to human keratinocyte and melalocyte cultures inhibited their proliferation in a dosdependent manner. 2. Calcipotriol had no effects on the melanization process of the melanocyte. 3. Calcipotriol was found to inhibit the proliferation, however it induced the terminal differentiation of cultured keratinocytes, as judged by morphologicai changes. The decreased density of kerationcytes, The formation of cornified cells, and the cellular destruction in a concentration of 10 M of calcipotriol were observed. 4. By using the light atid the electron microscope, we observed that the epidermal thickness was decreased and terminal differentiation was facilitateir. Living Skin Equivalent (LSE) according to the increasing concentration of calcipotriol. A]i)parent cytotoxic effects were observed in 10 M, 10 M of calcipotriol. In summary, the above results indicate that the addition of calcipotriol to the in vitro culture system of human keratinocyte and melanocyte induces the biologic process of terminal differentiation of keratinocytes and inhibits proliferation of keratinoytes and melanocytes in a dose-dependent manner.
Calcitriol ; Cholecalciferol* ; Foreskin ; Humans* ; Keratinocytes* ; Melanocytes* ; Skin ; Tics ; Vitamin D ; Vitamin E ; Vitamins*

Adenosine deaminase (adenosine aminohydrolase, AL)A), which catalyzes the deamination of adenosine to yield inosine and amrnonia, was assayed in human penile foreskin. The skin tissue was separated into two layers; epidermis and dermis. They were sliced with scissors into gel state, 4 volumes of 0.05M phosphate buffer solution were added and the tissue homogenized. After centrifugation at 4,000xg for 5 minutes, the supernatant was used as an enzyme solution. ADA activity was measured according to the method f Giuseppe" ADA was found to be present in both layers (epidermis; 0.24 OD/mg protein, dermis; 0.19 OD/mg protein) with slightly higher activity in the epidermis. As in earlier reports, it was found that ADA in the skin showed nearly even activity in the pH range of 5.0-8.0. Considering the significance of ADA in immunological function, the presence of ADA in the skin suggests that the tissue may participate in the immune function.
Adenosine Deaminase* ; Adenosine* ; Centrifugation ; Deamination ; Dermis ; Epidermis ; Foreskin ; Humans* ; Hydrogen-Ion Concentration ; Inosine ; Skin*

OBJECTIVETo evaluate the effect of the transverse preputial island flap technique (Duckett's procedure) for hypospadias repair.

METHODSA total of 356 patients with hypospadias were treated by Duckett's procedure from March 1995 to December 2010, of whom 324 (91.0%) were younger than 14 years. The length of urethra repair ranged from 1.5 to 10 cm.

RESULTSThe total success rate of Duckett's procedure was 91.0%. Urethra fistula occurred in 30 cases, external orifice stricture in 1, and urethral anastomosis stricture in another. There were no significant differences in the rate of complications among either different age groups or different surgical times (P > 0.05).

CONCLUSIONDuckett's procedure remains the first choice for the one-stage repair of hypospadias, especially applicable to hypospadias with chordee.

Adolescent ; Adult ; Child ; Child, Preschool ; Foreskin ; surgery ; Humans ; Hypospadias ; surgery ; Infant ; Male ; Surgical Flaps ; Young Adult

OBJECTIVETo search for a simple surgical procedure for the treatment of concealed penis that may have better effect and less complications.

METHODSWe used a modified surgical method in the treatment of 58 patients with concealed penis aged from 3 to 15 (mean 6.8) years. The operation was simplified and involved the following steps: wholly unveiling the penis glans, half-degloving the foreskins, cutting off all the adhesive fibers up to the penile suspensory ligaments, and liberating the external penis.

RESULTSThe operation was successful in all the patients, with the operative time of 15 -45 (mean 33) minutes, hospital stay of 2 - 5 (mean 3.5) days, but no complications except mild foreskin edema in 5 cases. The external penis was prolonged from 0.5 - 2.8 (mean 1.4) cm preoperatively to 3.2 - 8.5 (mean 3.9) cm postoperatively. The patients were followed up for 1 -3 years, all satisfied with the length and appearance of the penis, and their sexual and reproductive functions were normal.

CONCLUSIONThe modified surgical procedure for concealed penis is simple and effective, with desirable outcomes, few postoperative complications and no damage to sexual and reproductive functions.

Adolescent ; Child ; Child, Preschool ; Foreskin ; surgery ; Humans ; Male ; Penis ; abnormalities ; surgery ; Reconstructive Surgical Procedures ; methods

We present a 40-year-old woman who had a well circumscribed, pea sized red-brown glistening erosive papule on the foreskin of clitoris for four months which had been resistant to various forms of treatment. Histopathologic examination revealed flattened epidermis with lozenge keratinocytes and watery spongiosis, In the upper dermis, dense bandlike infiltration of plasma cells, endothelial proliferation, and capillary dilatation were noted. Peroxidase-antiperoxidase stain showed polyclonal pattern of reaction in the cytoplasm of plasma cells.
Adult ; Capillaries ; Clitoris ; Cytoplasm ; Dermis ; Dilatation ; Epidermis ; Female ; Foreskin ; Humans ; Keratinocytes ; Peas ; Plasma Cells ; Vulvitis*

BACKGROUND: Trans-4-aminomethylcyclohexanecarboxylic acid (tranexamic acid) has recently been reported to inhibit prostaglandin synthesis and hinder the pigmentation caused after UV radiation. OBJECTIVE: we evaluated the influence of tranexamic acid on the viability, morphogenesis and melanization of cultured normal human melanocytes. METHOD: The cultured melanocytes from neonatal foreskin were exposed to UVB 20mJ/cm2, then treated with tranexamic acid [0.05microgram/ml, 0.05microgram/ml, and 0.5microgram/ml]. After 24 hours, the viability of melanocytes and the melanin concentration was measured. The number and length of the melanocytes' dendrites, and the expression level of tyrosinase, TRP-1 and TRP-2 were also evaluated. RESULTS: The viability of the melanocytes was decreased by tranexamic acid in a dose dependent manner (p<0.05). The increased melanin synthesis by UVB irradiation was decreased by tranexamic acid in a dose dependent manner (p<0.05). Also, the increased expressions of TRP-1, TRP-2 and tyrosinase after exposure to UV were statistically decreased by tranexamic acid in a dose dependent manner (p<0.05). CONCLUSION: tranexamic acid may prevents UVB induced pigmentation.
Dendrites ; Foreskin ; Humans* ; Melanins ; Melanocytes* ; Monophenol Monooxygenase ; Morphogenesis ; Pigmentation ; Tranexamic Acid