eMedicine Specialties > Dermatology > Benign Neoplasms

Pearly Penile Papules

Author: Clarence William Brown Jr, MD,, Assistant Professor of Dermatology, Dermatologic and Mohs Micrographic Surgery, Rush University Medical Center
Contributor Information and Disclosures

Updated: Nov 13, 2009

Introduction

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 eMedicine articles, Dermatologic Diseases of the Male Genitalia: Malignant and Dermatologic Diseases of the Male Genitalia: Nonmalignant.

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.

Frequency

United States

The incidence of pearly penile papules reportedly ranges from 8-48%.1 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.
  • Rehbein2 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.3

Clinical

History

  • Most patients with pearly penile papules seek dermatologic consultation because they are concerned about a sexually transmitted disease.
  • Pearly penile papules most commonly are confused with condyloma acuminatum (genital warts) or less often, with molluscum contagiosum.4

Physical

  • Upon physical examination, pearly penile papules appear as one or several rows of small, flesh-colored, smooth, dome-topped to filiform papules situated circumferentially around the corona or sulcus of the glans penis (Media File 1). Uncommonly, lesions may extend onto the glans penis.
  • Pearly penile papules typically are asymptomatic and persist throughout life; however, they gradually may become less noticeable with increased age.

Pearly penile papules are seen clinically as mult...

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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Pearly penile papules are seen clinically as mult...

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.


Causes

  • Some evidence suggests that pearly penile papules may be observed more frequently in uncircumcised men (22%) than in circumcised men (12%).
  • In the past, pearly penile papules were believed to contribute to the accumulation of smegma in uncircumcised men; currently however, this is known to be not true.

More on Pearly Penile Papules

Overview: Pearly Penile Papules
Differential Diagnoses & Workup: Pearly Penile Papules
Treatment & Medication: Pearly Penile Papules
Follow-up: Pearly Penile Papules
Multimedia: Pearly Penile Papules
References
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References

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

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

  3. 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].

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

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

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

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

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

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

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

  11. 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].

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

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

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

  15. 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].

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

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Further Reading

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Keywords

pearly penile papules, angiofibromas, hirsute papillary corona of the penis, hirsutoid papillomas, papillae of the corona of the glans, papillae of the corona of the glans penis, papillomatosis corona penis, Tyson glands, Tyson's glands, uncircumcised males, lesions of the sulcus of the glans penis, lesions of the corona of the glans penis

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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 and American College of Mohs Micrographic Surgery and Cutaneous Oncology
Disclosure: Nothing to disclose.

Medical Editor

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 Ownership interest Consulting

Pharmacy Editor

Michael J Wells, MD, Associate Professor, Department of Dermatology, Texas Tech University Health Sciences Center
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.

Managing Editor

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.

CME Editor

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 None; Genentech Consulting fee Consulting; Centocor Consulting fee Consulting; Centocor Grant/research funds None; Covance Consulting fee Consulting; Shire  Consulting

Chief Editor

Dirk M Elston, MD, Director, Department of Dermatology, Geisinger Medical Center
Dirk M Elston, MD is a member of the following medical societies: American Academy of Dermatology
Disclosure: Nothing to disclose.

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