Pearly penile papules
Other names: Papillomatosis corona penis, corona capillitii, hirsuties coronae glandis, papillae coronis glandis, hirsutoid papillomas, hirsuties coronae glandis[1][2]
Glans penis with pearly penile papules
Specialty	Dermatology
Symptoms	Painlesssmall bumps on ridge ofglans of thepenis[2]
Usual onset	Age 20-30 years[3]
Diagnostic method	Examination[3]
Differential diagnosis	Genital warts,molluscum contagiosum,sebaceous hyperplasia,lichen nitidus[2]
Treatment	Reassurance, generally no treatment necessary[3]
Prognosis	Not harmful, regress spontaneously, recurrence rare[3]
Frequency	Up to half of young males[1]

Pearly penile papules (PPPs) arenormalsmall bumps that can occur on thepenis.^[2][3] They vary in size from 1 - 4 mm, are white or flesh-colored, smooth and dome-topped, and appear in one or several rows around theridge of the head of the penis and sometimes on the shaft.^[2][4] In a Black person, they generally appear whitish.^[5] They are painless,non-cancerous, and harmless.^[2]

They are a type ofangiofibroma, whose function is not well-understood.^[3][1] They are sometimes described asremnants ofpenile spines, a sensitive feature found in the same location in otherprimates.^[6] PPPs secrete oil that moistens the head of the penis.^[7] Diagnosis is by visualization.^[3] Ondermoscopy, they appear in a cobblestone-like pattern, with a central dotted or comma-shaped blood vessels, and without scaling.^[1] Examination of atissue biopsy shows denseconnective tissue,fibroblasts, and many blood vessels.^[4] They are sometimes mistaken forgenital warts,molluscum contagiosum,sebaceous hyperplasia, orlichen nitidus.^[8][2]

Generally, reassurance is given and no treatment is needed.^[3] Following counselling,cryotherapy,laser therapy, orshave excision may be options for cosmetic reasons.^[9][3] Some home remedies involving corrosive substances can be damaging.^[10] They do not spread and often spontaneously regress.^[11]

PPPs are common, occurring in up to half of young males.^[1][2] They are more common inuncircumcised people.^[2] They were first described in 1700 and the term "pearly penile papules" was coined in 1964.^[1] Some find them distressing to look at, owing to their resemblance to somesexually transmitted infections.^[1][12]

Signs and symptoms

PPPs aresmall bumps on thehuman penis.^[2] They vary in size from 1 - 4 mm, are pearly or flesh-colored, smooth and dome-topped or filiform, and appear in one or several rows around thecorona, the ridge of theglans and sometimes on the penile shaft.^[2][4] In a black person, the bumps may appear whitish.^[5] They are painless,non-cancerous and not harmful.^[2]

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  Pearly penile papules

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  Pearly penile papules

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  Single pearly penile papule on glans

Cause and mechanism

PPPs are a type ofangiofibroma.^[3] Their function is not well-understood.^[1][13] They are sometimes described asvestigial remnants ofpenile spines, sensitive features found in the same location in other primates.^[6] PPPs secrete oil that moistens the glans of the penis.^[7] They do not spread and often regress spontaneously.^[11] Along withFordyce glands PPPs secrete oils to keep the skin of thehead of penis in good condition.^[7]Smegma can accumulate if these oils are produced in excess or there is inadequate washing under the foreskin.^[7] There is no association withhuman papilloma virus^[1] The bumps are analogous tovestibular papillomatosis in women.^[14]'

Diagnosis

Diagnosis is by visualisation.^[3] Ondermoscopy, the white-pink papules appear in a cobblestone-like pattern and contain a central dotted or comma-shaped blood vessels. There is no scale.^[1] PPPs are sometimes mistaken forgenital warts due to a perceived similarity in appearance.^[8] They can also appear similar tomolluscum contagiosum,sebaceous hyperplasia andlichen nitidus.^[2] Histopathology shows denseconnective tissue,fibroblasts and many blood vessels.^[4]

Treatment

Generally, reassurance is given and no treatment is needed.^[3][15] Laser or cryotherapy may be considered for men who find PPPs distressing to look at or feel excessive embarrassment.^[1]

Carbon dioxide laser generally has good outcomes with skin healing within 7 days.^[1] The procedure requires anaesthesia, may need to be performed more than once, and has a risk of bleeding, scarring and colour changes.^[1] Another procedure involves ahyfrecator.^[16]

Epidemiology

PPPs are common and occur in around up to 48% of young males.^[1][2] They are more common in uncircumcised males.^[2]

History

PPPs were first described byAlexis Littré in 1700 and the term pearly penile papules was coined in 1964.^[1]

Society and culture

Although it is not related to anydisease, PPPs are occasionally mistaken forHPV warts.^[1] There are alsohome remedies for "curing" it, despite the fact that the papules are neither infectious nor detrimental to one's health and may have beneficial functions.^[7][12] Some of the "home remedies" found on the Internet and elsewhere use mild ointments or creams to soften the papules, but others are physically dangerous techniques for papule removal which can result in permanent genital mutilation.^[10]

With safe, effective ways to remove the papules if desired, home remedies involving corrosive substances or self-surgery can be damaging.^[10]

References

External links

• Pages with script errors
• Dermal and subcutaneous growths
• Human penis anatomy
• Andrology
• Human male reproductive system
• RTT