Pearly Penile Papules
- Author: Clarence William Brown Jr, MD; Chief Editor: William D James, MD more...
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.
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]
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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Rehbein HM. Pearly penile papules: incidence. Cutis. Jan 1977;19(1):54-7. [Medline].
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].
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Ackerman AB, Kronberg R. Pearly penile papules. Acral angiofibromas. Arch Dermatol. Nov 1973;108(5):673-5. [Medline].
Agrawal SK, Bhattacharya SN, Singh N. Pearly penile papules: a review. Int J Dermatol. Mar 2004;43(3):199-201. [Medline].
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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].
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