Pearly penile papules (PPP) are benign small bumps on the human penis. They vary in size from 1–4 mm, are pearly or flesh-colored, smooth and dome-topped or filiform, and appear in one or several rows around the corona, the ridge of the head of the penis and sometimes on the penile shaft. They are painless, non-cancerous and not harmful.

Symptoms and signs

PPPs are small bumps on the human penis. They vary in size from 1–4 mm, are pearly or flesh-colored, smooth and dome-topped or filiform, and appear in one or several rows around the corona, the ridge of the glans and sometimes on the penile shaft. They are painless, non-cancerous and not harmful.

Cause and mechanism

Hirsuties papillaris coronae glandis enlarged

PPPs are a type of angiofibroma. Their function is not well-understood. They are sometimes described as vestigial remnants of penile spines, sensitive features found in the same location in other primates. PPPs secrete oil that moistens the glans of the penis. They do not spread and often spontaneously regress. Along with Fordyce glands PPPs secrete oils to keep the skin of the head of penis in good condition.

Smegma Smegma (Ancient Greek σμῆγμα : ''smēgma'') is a combination of shed skin cells, skin oils, and moisture. It occurs in both male and female mammalian genitalia. In females, it collects around the clitoris and in the folds of the labia min ...

can accumulate if these oils are produced in excess or there is inadequate washing under the foreskin.

Diagnosis

Diagnosis is by visualisation. On

dermoscopy Dermatoscopy also known as dermoscopy or epiluminescence microscopy, is the examination of skin lesions with a dermatoscope. It is a tool similar to a camera to allow for inspection of skin lesions unobstructed by skin surface reflections. The de ...

, the white-pink papules appear in a cobblestone-like pattern and contain a central dotted or comma-shaped blood vessels. There is no scale. PPPs are sometimes mistaken for genital warts due to a perceived similarity in appearance. They can also appear similar to molluscum contagiosum,

sebaceous hyperplasia Sebaceous hyperplasia is a disorder of the sebaceous glands in which they become enlarged, producing flesh-colored or yellowish, shiny, often umbilicated bumps on the face. Newly formed nodules often swell with sweating (which is pathognomonic for ...

and lichen nitidus. Histopathology shows dense

connective tissue Connective tissue is one of the four primary types of animal tissue, along with epithelial tissue, muscle tissue, and nervous tissue. It develops from the mesenchyme derived from the mesoderm the middle embryonic germ layer. Connective tiss ...

, fibroblasts and many blood vessels.

Treatment

Generally, reassurance is given and no treatment is needed. Laser or cryotherapy may be considered for men who find PPPs distressing to look at or feel excessive embarrassment. Carbon dioxide laser generally has good outcomes with skin healing within seven days. The procedure requires anaesthesia, may need to be performed more than once, and has a risk of bleeding, scarring and colour changes. Another procedure involves a

hyfrecator A hyfrecator is a low-powered medical apparatus used in electrosurgery on conscious patients, usually in an office setting. It is used to destroy tissue directly, and to stop bleeding during minor surgery. It works by emitting low-power high-frequ ...

Epidemiology

PPPs are common and occur in 14% to 48% of young males. They are less common in

circumcised Circumcision is a surgical procedure, procedure that removes the foreskin from the human penis. In the most common form of the operation, the foreskin is extended with forceps, then a circumcision device may be placed, after which the foreskin ...

males, occurring about half as frequently in circumcised men.

Social and cultural

Some men find PPPs distressing to look at, owing to their resemblance to some sexually transmitted infections. Although it is not related to any

disease A disease is a particular abnormal condition that negatively affects the structure or function of all or part of an organism, and that is not immediately due to any external injury. Diseases are often known to be medical conditions that a ...

, PPPs are occasionally mistaken for HPV warts. There are also

home remedies Traditional medicine (also known as indigenous medicine or folk medicine) comprises medical aspects of traditional knowledge that developed over generations within the folk beliefs of various societies, including indigenous peoples, before the ...

for "curing" it, despite the fact that the papules are neither infectious nor detrimental to one's health and may have beneficial functions. Some of the "home remedies" found on the Internet and elsewhere use mild ointments or creams to soften the papules, but others are physically dangerous techniques for papule removal which can result in irreversible damage. Rapini ''et al.'' advise that, since dermatologists have safe, effective ways to remove the papules if desired, home remedies involving corrosive substances or self-surgery should be avoided, since they can permanently damage sexual functioning. Rapini ''et al.'' further state that removal should only be performed by a physician using proven medical techniques.

References

External links

{{DEFAULTSORT:Hirsuties Papillaris Genitalis Dermal and subcutaneous growths Human penis anatomy Andrology Human male reproductive system