|Year : 1992 | Volume
| Issue : 5 | Page : 334-335
Pearly penile papules
AK Jaiswal, B Bhushan
A K Jaiswal
Source of Support: None, Conflict of Interest: None
In this study of 476 men, 113 (23.74%) were found to have pearly penile papules. Fourteen (12.38%) cases had been misdiagnosed as genital warts by general physicians.
Keywords: Pearly penile papules
|How to cite this article:|
Jaiswal A K, Bhushan B. Pearly penile papules. Indian J Dermatol Venereol Leprol 1992;58:334-5
| Introduction|| |
Pearly penile papules (PPP) are small smooth asymptomatic dome-shaped or hair like papules involving penile corona. Their colour tends to be pearly white. They appear to be physiological variants without functional significance. PPP may be confused with some form of genital warts or tumours, leading to misdiagnosis and inappropriate treatment. The only reported study from India on the prevalence rate of PPP included mainly patients treated at a STD clinic.  The present study was undertaken to examine the prevalence of PPP in both STD as well as non-STD groups of individuals.
| Material and Methods|| |
Two hundred and forty patients with STD and 236 healthy subjects with no history of STD comprised the clinical material for the study. All of them were examined for the presence of PPP. In addition, data were collected on age, marital status, presence of circumcision, symptoms, concomitant STDs, relation to sexual exposure, masturbation, and duration of the patient's awareness of the papules. Patients with only a few tiny lesions were counted as negative. Only those with an undisputed presence of many PPP were counted positive.
| Results|| |
The overall prevalence of PPP was 23.74% (113 out of 476), the prevalence being 25.42% (61 of 240) in STD group and 22.03% (52 of 236) in non-STD group. Only papular structures were observed rather than papillary, verruciform or glandular structures. We found 12.38% (14) PPP cases being misdiagnosed as genital warts by general medical practitioners and 4 of them were even unsuccessfully treated with podophyllin.
Age: Subjects in the study ranged in age from 17 to 52 years, the average being 25 years. STD patients with PPP were from 19-39 years age group, the average being 24 years, whereas the average age in non-STD group was 21 years. No PPP was found in the age group of 40 years and above.
Circumcision: Twenty percent (95) of the subjects had been circumcised, the remaining 80% (381) were uncircumcised. Of those circumcised 10.53% (10) had PPP and of those uncircumcised 27.03% (103) had PPP.
Duration: Thirty two percent of the individuals were totally unaware that they had lesions. Of the remaining, duration of awareness of the lesions varied from 4 months to 5 years.
Symptoms: Only 1 patient had symptoms amounting to venereophobia. The remaining individuals were totally asymptomatic.
Statistical analysis showed no significant relationship of PPP to promiscuity, masturbation, type of STD, and marital status.
| Comments|| |
Lesions similar to PPP were described as early as 1700 by Littre. In 1888 Duhring described similar lesions thinking them to be nerve organs.  These lesions have variously been described as papillae in corona glandis, Tyson glands, hirsutoid papules, and corona capilliti. Histopathologically, they consist of an outer keratinizing epidermis with a central fibrous core. They are best considered as angiofibromas.
The prevalence rate of PPP has been reported from 8% to 20.27% ,,,, In our study it was 23.73%. Hence we feel that PPP occurs more frequently than previously reported. There was no significant difference in prevalence among STD and non-STD group of individuals. We also found a higher prevalence in uncircumcised males (27.03% versus 10.53%). This is similar to the findings of most workers. ,,,
Majority of the cases (74.33%) were observed to be in the age group of 20-25 years. This corresponds well with the observation of other workers. 
Venereophobia in PPP patients has been reported to be as high as 20% by Cyriac et al.  Conversely, we found presence of venereophobia in only 1 patient. Hence, in our experience, majority of those who have PPP either do not bother about it or are easily convinced of the nature of the lesion on explanation.
As high as 12.38% of our cases were misdiagnosed as genital warts by general physicians. Besides, 4 of them were even unnecessarily treated with potentially painful results. PPP requires no treatment other than reassurance to the patient.
| References|| |
|1.||CyriacMJ, GopinathanT, ChakarapaniCM. Incidence of pearly penile papules-among STD patients. Ind J Dermatol Venereol Leprol 1984; 50 : 206-8. |
|2.||Ackerman A B, Kornberg R. Pearly penile papules. Arch Dermatol 1973; 108 : 673-5. |
|3.||Glicksman J M, Freeman R G. Pearly penile papules : a statistical study of incidence. Arch Dermatol 1966 : 93 : 56-9. |
|4.||Lawrence SN, Goldenring J. Pink pearly panile papules : an epidemiological study. J Paediatrics 1966 : 105 : 594-5. |
|5.||Tannenbaun M H, Beekers S W. Pearly penile papules. J Urol 1965 ; 93 : 391-3. |