Smegma pearl.

A 4-year-old uncircumcised Indian boy presented with a painless whitish-yellow 0.8 × 1.2 cm pearly nodule over the glans [Figure 1]. The prepuce was partially retractable, with a thin inner preputial membrane attached to the glans mucosa. Application of gentle retractile pressure over the nodule released odorless cheese-like whitish material [Figure 2] rendering the prepuce free from the glans. This nodule of entrapped smegma, termed “smegma pearl” is fairly common in young uncircumcised boys. Despite expected spontaneous resolution, parents become apprehensive. Smegma pearl is a benign collection of smegma accumulated in the subpreputial space of young uncircumcised boys. Despite being common, it has been reported only recently.[1] The major differentials including preputial cysts, preputial Epstein pearls, and preputial median raphe cysts are easily clinically discernible.[12]

Figure 1

The ovoid smegma pearl located adjacent to the frenulum between the base of the glans and the distal junction of its attachment with the preputial membrane

Figure 2

Release of smegma, a whitish cheesy material from the pearly lesion on application of gentle retractile pressure

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