The male external genitalia are composed of the penis and scrotum. The penis is divided into the more distal glans and the shaft or body, which is anchored by its root in the perineal pouch. The prepuce (foreskin) covers the glans. It is a thin loose covering of keratinizing skin with associated underlying eccrine (sweat) and sebaceous glands and a highly vascular stroma without underlying adipose (fat) tissue.
The prepuce (foreskin) is composed of the following 5 layers:
1. external keratinizing epidermis
2. underlying dermis with eccrine and sebaceous glands
3. fine strands of dartos muscle
4. lamina propria
5. internal squamous mucosa
The glans is an extension of the highly vascular corpus spongiosum and is covered by squamous epithelium that is keratinized in the circumcised male. The scrotum extends the keratinized squamous epithelium with underlying dartos muscle and associated external spermatic fascia. Here, the dermis contains hair follicles in association with eccrine, apocrine, and sebaceous glands. Scattered fat cells are present, although well-formed subcutaneous adipose tissue usually is not.
Most dermatologic disorders are confined to the epidermis, underlying dermis, and associated adnexal structures. These areas include the keratinized epithelium, the underlying dermis with its rich vasculature, associated smooth muscle, associated hair follicles and sweat and sebaceous glands.
Dermatologic anatomy of the male genitalia.
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