By Gary M. White, MD
Courtesy O. Dale Collins, MD
The median raphe cyst (MRC) is thought to represent a fusion defect or entrapment during the embryonic development of the raphe.
An asymptomatic (unless infected) cyst which may form along the raphe from the glans to the anus is characteristic. It may become infected at puberty or soon after with Staph, Neisseria gonorrhoeae or simple trauma from intercourse, resulting in acute inflammation and enlargement. Culture for gonorrhea should be done. Inquiry as to penile discharge or other signs of sexually transmitted disease is appropriate. Multiple congenital milia along the median raphe have been reported [BJD 1996;134;376].
Simple surgical excision may be performed. Observation alone may be appropriate with intervention anticipated if symptoms arise.
A 7-month-old boy presented with linearly arranged, multiple pinhead-sized to rice-sized whitish cysts along the median raphe from the perineum to the penile shaft which were present from birth and progressively increased in size and number. Ann Dermatol. 2016 Jun; 28(3): 398–399
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