Laboratory studies are not indicated for pearly penile papules.
Imaging studies are not indicated for pearly penile papules.
Confirmation of a diagnosis of pearly penile papules may be obtained by obtaining a biopsy specimen of a lesion for histopathologic analysis.
Histopathologic analysis of lesions demonstrates a variable number of thin-walled ectatic vessels in the dermis in association with a fibroblastic proliferation. Lesional fibroblasts may appear stellate or multinucleated. Concentric fibrosis surrounding adnexal structures is an additional characteristic.
These features are seen in angiofibromas and are not specific for pearly penile papules. Angiofibromas associated with tuberous sclerosis (adenoma sebaceum) and fibrous papules may show identical histologic findings. Clinical history or recognition of genital skin (in adequate biopsy sample) may provide a specific diagnosis.
No staging system exists or is necessary, given the benign and innocuous nature of pearly penile papules.
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