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Pearly Penile Papules

  • Author: Clarence William Brown, Jr, MD, FAAD; Chief Editor: William D James, MD  more...
 
Updated: Apr 05, 2016
 

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. 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.

See the images below.

Pearly penile papules. Courtesy of Wiki Commons Pearly penile papules. Courtesy of Wiki Commons
Pearly penile papules; close-up view. Courtesy of Pearly penile papules; close-up view. Courtesy of Wiki Commons.

Also see the two related Medscape 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 undergo 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.

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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Prognosis

Pearly penile papules typically are asymptomatic and persist throughout life, although lesions gradually may become less noticeable with advancing age.

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Patient Education

Educate patients about the benign nature of pearly penile papules. Inform patients that lesions are not transmitted through sexual activity. Consider counseling for the patient's sexual partner, which often helps alleviate anxiety.

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Contributor Information and Disclosures
Author

Clarence William Brown, Jr, MD, FAAD Chief Executive Officer, University Dermatology

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

Disclosure: Nothing to disclose.

Specialty Editor Board

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

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

Disclosure: Nothing to disclose.

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, Society for Investigative Dermatology

Disclosure: Nothing to disclose.

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. 2009 Nov. 20(11):768-70. [Medline].

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

  3. Rehbein HM. Pearly penile papules: incidence. Cutis. 1977 Jan. 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. 2009 Nov. 20(11):768-70. [Medline].

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

  6. Rane V, Read T. Penile appearance, lumps and bumps. Aust Fam Physician. 2013 May. 42 (5):270-4. [Medline].

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

  8. Gouveia AI, Borges-Costa J, Soares-Almeida L. Atypical pearly penile papules mimicking primary syphilis. Acta Dermatovenerol Croat. 2014 Dec. 22(4):311-2. [Medline].

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

  10. Micali G, Lacarrubba F. Augmented diagnostic capability using videodermatoscopy on selected infectious and non-infectious penile growths. Int J Dermatol. 2011 Dec. 50(12):1501-5. [Medline].

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

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

  13. Krakowski AC, Feldstein S, Shumaker PR. Successful Treatment of Pearly Penile Papules with Carbon Dioxide Laser Resurfacing After Local Anesthesia in an Adolescent Patient. Pediatr Dermatol. 2014 Dec 29. [Medline].

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

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

  16. Gan SD, Graber EM. Treatment of Pearly Penile Papules with Fractionated CO2 Laser. J Clin Aesthet Dermatol. 2015 May. 8 (5):50-2. [Medline].

  17. Sapra P, Sapra S, Singh A. Pearly penile papules: effective therapy with pulsed dye laser. JAMA Dermatol. 2013 Jun. 149(6):748-50. [Medline].

  18. Baumgartner J. Erbium: yttrium-aluminium-garnet (Er:YAG) laser treatment of penile pearly papules. J Cosmet Laser Ther. 2012 Jun. 14(3):155-8. [Medline].

  19. Ocampo-Candiani J, Cueva-Rodriguez JA. Cryosurgical treatment of pearly penile papules. J Am Acad Dermatol. 1996 Sep. 35(3 Pt 1):486-7. [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.
Pearly penile papules. Courtesy of Wiki Commons
Pearly penile papules; close-up view. Courtesy of Wiki Commons.
 
 
 
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