Pearly Penile Papules 

  • Author: Clarence William Brown Jr, MD; Chief Editor: William D James, MD   more...
 
Updated: Mar 28, 2012
 

Background

Pearly penile papules are small dome-shaped to filiform skin-colored papules that typically are located on the sulcus or corona of the glans penis. Commonly, pearly penile papules are arranged circumferentially in one or several rows and often are assumed wrongly to be transmitted sexually.

Also see the 2 related Medscape Reference articles, Dermatologic Diseases of the Male Genitalia: Malignant and Dermatologic Diseases of the Male Genitalia: Nonmalignant.

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Pathophysiology

Pearly penile papules are considered a normal variant and harbor no malignant potential. They are not contracted or spread through sexual activity.

Pearly penile papules are observed more frequently in uncircumcised males; however, the mechanisms underlying their development remain unknown. Interestingly, in uncircumcised males with pearly penile papules who under go circumcision later in life, regression of the papules is commonly observed.[1]

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Epidemiology

Frequency

United States

The incidence of pearly penile papules reportedly ranges from 8-48%.[2] Several reports suggest an increased incidence of pearly penile papules in uncircumcised versus circumcised men (22% vs 12%, respectively). One study found an increase in frequency in black versus white men, in those circumcised (21% vs 7%, respectively) and uncircumcised (44% vs 33%, respectively).

International

No geographic variation in prevalence has been noted for pearly penile papules.

Mortality/Morbidity

Pearly penile papules are considered to be a normal variant and are unrelated to sexual activity. Often, lesions cause great anxiety to patients until their benign nature is clarified.

Race

No racial predilection has been confirmed for pearly penile papules. Reports suggesting an increased incidence in African American males may reflect an increase in uncircumcised men in that population.

Rehbein[3] studied 840 men aged 10-66 years and found an overall incidence of pearly penile papules of 30.1% in this group. Black men in the study demonstrated a rate of pearly penile papules of 32.7% (44% in uncircumcised, 20.8% in circumcised black males). White men in the study demonstrated a rate of 13.9% (33.3% in uncircumcised, 7.1% in circumcised white males).

Sex

Because of their anatomic distribution, pearly penile papules are noted only in men.

Age

Pearly penile papules are noted most commonly in males in their second or third decades of life, with a gradual decrease in frequency with aging.[1, 4]

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Contributor Information and Disclosures
Author

Clarence William Brown Jr, MD  Assistant Professor of Dermatology, Dermatologic and Mohs Micrographic Surgery, Rush University Medical Center

Clarence William Brown Jr, MD, is a member of the following medical societies: American Academy of Dermatology, American College of Mohs Micrographic Surgery and Cutaneous Oncology, American Medical Association, Chicago Dermatological Society, Chicago Medical Society, Illinois Dermatological Society, and Illinois State Medical Society

Disclosure: Nothing to disclose.

Specialty Editor Board

James Fulton Jr, MD, PhD  Center for Cosmetic Dermatology; Consultant, Vivant Pharmaceuticals, LLC

James Fulton Jr, MD, PhD is a member of the following medical societies: American Academy of Cosmetic Surgery, American Academy of Dermatology, American Society for Laser Medicine and Surgery, Dermatology Foundation, International Society of Cosmetic and Laser Surgeons, and Skin Cancer Foundation

Disclosure: Vivant Pharmaceuticals Grant/research funds Consulting

Michael J Wells, MD  Associate Professor, Department of Dermatology, Texas Tech University Health Sciences Center, Paul L Foster School of Medicine

Michael J Wells, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American Medical Association, and Texas Medical Association

Disclosure: Nothing to disclose.

Lester F Libow, MD  Dermatopathologist, South Texas Dermatopathology Laboratory

Lester F Libow, MD is a member of the following medical societies: American Academy of Dermatology, American Society of Dermatopathology, and Texas Medical Association

Disclosure: Nothing to disclose.

Joel M Gelfand, MD, MSCE  Medical Director, Clinical Studies Unit, Assistant Professor, Department of Dermatology, Associate Scholar, Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania

Joel M Gelfand, MD, MSCE is a member of the following medical societies: Society for Investigative Dermatology

Disclosure: AMGEN Consulting fee Consulting; AMGEN Grant/research funds Investigator; Genentech Grant/research funds investigator; Centocor Consulting fee Consulting; Abbott Grant/research funds investigator; Abbott Consulting fee Consulting; Novartis investigator; Pfizer Grant/research funds investigator; Celgene Consulting fee DMC Chair; NIAMS and NHLBI Grant/research funds investigator

Chief Editor

William D James, MD  Paul R Gross Professor of Dermatology, Vice-Chairman, Residency Program Director, Department of Dermatology, University of Pennsylvania School of Medicine

William D James, MD is a member of the following medical societies: American Academy of Dermatology and Society for Investigative Dermatology

Disclosure: Elsevier Royalty Other

References

  1. Agha K, Alderson S, Samraj S, Cottam A, Merry C, Lee V, et al. Pearly penile papules regress in older patients and with circumcision. Int J STD AIDS. Nov 2009;20(11):768-70. [Medline].

  2. Sonnex C, Dockerty WG. Pearly penile papules: a common cause of concern. Int J STD AIDS. Nov 1999;10(11):726-7. [Medline].

  3. Rehbein HM. Pearly penile papules: incidence. Cutis. Jan 1977;19(1):54-7. [Medline].

  4. Agha K, Alderson S, Samraj S, et al. Pearly penile papules regress in older patients and with circumcision. Int J STD AIDS. Nov 2009;20(11):768-70. [Medline].

  5. Monroe JR. Does this man have genital warts? Pearly penile papules. JAAPA. Feb 2009;22(2):16. [Medline].

  6. Watanabe T, Yoshida Y, Yamamoto O. Differential diagnosis of pearly penile papules and penile condyloma acuminatum by dermoscopy. Eur J Dermatol. Feb 22 2010;[Medline].

  7. Ozeki M, Saito R, Tanaka M. Dermoscopic features of pearly penile papules. Dermatology. 2008;217(1):21-2. [Medline].

  8. Ozeki M, Saito R, Tanaka M. Dermoscopic features of pearly penile papules. Dermatology. 2008;217(1):21-2. [Medline].

  9. Lane JE, Peterson CM, Ratz JL. Treatment of pearly penile papules with CO2 laser. Dermatol Surg. Jul 2002;28(7):617-8. [Medline].

  10. Magid M, Garden JM. Pearly penile papules: treatment with the carbon dioxide laser. J Dermatol Surg Oncol. May 1989;15(5):552-4. [Medline].

  11. Beylot C. [What's new in aesthetic dermatology: filler and laser treatments]. Ann Dermatol Venereol. May 2009;136 Suppl 4:S152-9. [Medline].

  12. Rokhsar CK, Ilyas H. Fractional resurfacing for the treatment of pearly penile papules. Dermatol Surg. Oct 2008;34(10):1420-2; discussion 1422. [Medline].

  13. Ocampo-Candiani J, Cueva-Rodriguez JA. Cryosurgical treatment of pearly penile papules. J Am Acad Dermatol. Sep 1996;35(3 Pt 1):486-7. [Medline].

  14. Ackerman AB, Kronberg R. Pearly penile papules. Acral angiofibromas. Arch Dermatol. Nov 1973;108(5):673-5. [Medline].

  15. Agrawal SK, Bhattacharya SN, Singh N. Pearly penile papules: a review. Int J Dermatol. Mar 2004;43(3):199-201. [Medline].

  16. Glicksman JM, Freeman RG. Pearly penile papules. A statistical study of incidence. Arch Dermatol. Jan 1966;93(1):56-9. [Medline].

  17. Hogewoning CJ, Bleeker MC, van den Brule AJ, et al. Pearly penile papules: still no reason for uneasiness. J Am Acad Dermatol. Jul 2003;49(1):50-4. [Medline].

  18. Korber A, Dissemond J. Pearly penile papules. CMAJ. Sep 15 2009;181(6-7):397. [Medline].

 
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Pearly penile papules are seen clinically as multiple, glistening, flesh-colored, dome-topped papules arranged circumferentially in 2 rows along the corona of the glans penis.
 
 
 
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