Pearly Penile Papules Treatment & Management

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

Medical Care

Pearly penile papules typically are asymptomatic and require no therapy.

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Surgical Care

Some patients with pearly penile papules may request therapy to alleviate anxiety.

Ablation using carbon dioxide laser,[11, 12, 13] electrodesiccation with curettage, and excisional surgery reportedly have successfully eliminated pearly penile papules. Recent technological advancements in lasers have resulted in promising outcomes using newer fractional ablative approaches,[14, 15] including fractionated carbon dioxide lasers.[16] Successful treatment with pulsed dye laser has been reported,[17] as has treatment with erbium:yttrium-aluminium-garnet (Er:YAG) laser.[18]

Mixed results have been noted with cryotherapy.[19]

Topical application of podophyllin largely has been ineffective for pearly penile papules.

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Consultations

Consultation with a dermatologist may prove useful when the diagnosis is not obvious.

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Diet

Diet is not known to be a factor influencing the development or course of pearly penile papules.

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Activity

Pearly penile papules are not associated with personal hygiene or sexual activity.

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Complications

Pearly penile papules are not known to be associated with any complications.

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Prevention

Circumcision at birth may decrease the incidence of pearly penile papules, since the frequency of lesions is fewer in circumcised males (12%) versus uncircumcised males (22%).

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Long-Term Monitoring

Most patients accept that treatment is not necessary for pearly penile papules once the benign nature of the lesions is explained. Patients who insist on treatment may elect to undergo ablative therapy with conventional surgical excision or carbon dioxide laser resurfacing.

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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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