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.
Also see the two related Medscape articles, Dermatologic Diseases of the Male Genitalia: Malignant and Dermatologic Diseases of the Male Genitalia: Nonmalignant.
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. 
The incidence of pearly penile papules reportedly ranges from 8-48%.  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).
No geographic variation in prevalence has been noted for pearly penile papules.
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  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).
Because of their anatomic distribution, pearly penile papules are noted only in men.
Pearly penile papules typically are asymptomatic and persist throughout life, although lesions gradually may become less noticeable with advancing age.
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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