Case presentation:
A 2-month-old male infant was brought to a primary health center by his apprehensive mother who was concerned about a white nodule on his penis. The infant was voiding without difficulty and breastfeeding well. No similar lesions were noticed on the rest of the body or mucosal surfaces. There was no maternal history of sexually transmitted infections, and all the initial infection screenings, including HIV/Hepatitis B,C/Syphilis, were negative. The mother denied any trauma. The baby was born at full term to a multigravida mother via spontaneous vaginal delivery with a birth weight of 3.5kg, head circumference of 36cm, and length of 51cm. The clinical examination of the baby was unremarkable except for a white nodular lesion on the tip of the penis noted. Evaluation of the external genitalia revealed a 0.5 x 0.5 cm-sized, round, yellowish-white nodule over the penile foreskin. (Figure 1) The lesion was non-tender and soft in consistency. After discussing the diagnosis with the urologist, the mother was initially counseled regarding the benign nature of the condition. However, despite attempts at further counseling, the mother remained apprehensive and could not be fully reassured. So manual expression of the nodule by gentle pressure was performed, revealing white cheesy material and further confirming the diagnosis of Smegma pearl. At six-month follow-up visit, the nodular swelling has resolved and child was doing well.