Pearly penile papules
Pearly penile papules are frequently misdiagnosed as genital warts but are merely a normal anatomical variant in men. They appear as small, dome-shaped to filiform skin-colored papules that typically are located on the sulcus or corona of the glans penis. Lesions are generally are arranged circumferentially in one or several rows.
Pearly penile papules have no malignant potential. They are not contracted or spread through sexual activity. Lesions are observed more frequently in uncircumcised males; however, the mechanisms underlying their development remain unknown. Pearly penile papules are noted most commonly in males in their second or third decades, with a gradual decrease in frequency with aging.
The incidence of pearly penile papules reportedly ranges from 8-48%. Several reports suggest an increased incidence 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).
Obstet Gynecol 1991 Jul;78(1):118-22:
Pearly penile papules: absence of human papillomavirus DNA by the polymerase chain reaction.
Ferenczy A, Richart RM, Wright TC. Department of Pathology, Sir Mortimer B. Davis Jewish General Hospital, Montreal, Quebec, Canada.
"Pearly penile papules clinically resemble the sexually transmitted papular variant of genital condylomata. Histologically, however, pearly penile papules consist of fibropapillomata that lack the characteristic morphologic features of human papillomavirus (HPV) infection. To study the possible association of HPV infections with pearly penile papules, we examined tissue specimens from 13 men with pearly penile papules with and without associated penile condylomata.
Biopsy specimens were tested for the presence of HPV DNA by the polymerase chain reaction. None of the pearly penile papules contained HPV DNA sequences, whereas four of seven cases clinically suspected of being condylomata associated with pearly penile papules contained HPV DNA. These results confirm that pearly penile papule lesions do not contain HPV DNA; therefore, the distinction between pearly penile papules and penile condylomata is clinically significant."
Int J STD AIDS 1999 Nov;10(11):726-7:
Pearly penile papules: a common cause of concern.
Sonnex C, Dockerty WG. Department of Genitourinary Medicine, Addenbrooke's Hospital, Cambridge, UK.
"This study of two hundred men attending a department of genitourinary medicine documented a prevalence of pearly penile papules of 48%. Most men with papules had only a few lesions of less than 1 mm in size (73%). Nineteen per cent had papules of less than 1 mm in size extending around the corona and 8% had lesions greater than 1 mm in size extending around the corona. Over one-third of men with papules had previously been concerned or worried by their presence and approximately one-quarter had experienced embarrassment. Fourteen per cent of men with small lesions and 75% with larger lesions wished to have them removed. Two men with large and extensive papules underwent treatment by CO2 laser ablation with excellent cosmetic results."