Pearly penile papules
| Pearly penile papules | |
|---|---|
| Specialty | Urology  |
Hirsuties coronae glandis (also known as "hirsutoid papillomas,"[1] and "pearly penile papules"[1]) are small saliences on the ridge of the glans of the male genital organs. It is a harmless anatomical variation. They are found significantly more often on uncircumcised men and younger men.[2] They have been found to regress with aging and with circumcision.[3]
The papules appear as one or several rows of small, pearly or flesh-colored, smooth, dome-topped bumps situated circumferentially around the corona (see image) or sulcus of the glans penis. They range in size from less than 1 mm to 3 mm.[4] They are common and estimated to be present in a quarter of adult men.[5] Some men report that stimulation of these bumps contributes to their sexual pleasure.[citation needed] These bumps are not transmitted through sexual activity and are not a sexually transmitted disease (STD).
Hirsuties coronae glandis are sometimes described as vestigial remnants of "penile spines", sensitive features found in the same location in other primates. However, penile spines in chimps and mice are small surface projections made by piling up of keratinized cell layers in the outer most skin surface.[6][7] In contrast, the common structures found in humans are substantially larger, appear to be an outpocketing of both surface and underlying connective tissue layers, and lack the rich innervation seen in other animals.[8][9] Thus the relationship between the structures is still uncertain.[10] In the primate line from which humans may have evolved, a regulatory DNA sequence associated with the formation of small keratinized penile spines was lost.[11] This particular DNA sequence is missing in all humans tested, so cannot explain why some human males form penile papules and some do not.[10] In species which retain the full expression of penile spines, penile spines contribute to sexual pleasure and quicker orgasms.[12]
A similar expression, vestibular papillomatosis of the vulva or Hirsuties papillaris vulvae,[13] occurs in females and similarly can be misinterpreted as an outbreak of the HPV infection. Like hirsuties papillaris genitalis, it is a normal variation on human anatomy.[14]
Medical removal
While hirsuties papillaris genitalis pose no risk to a male's health or sex life, some men or their sexual partners may consider them aesthetically displeasing.[15] There are several medical ways to remove them. Like any elective medical procedure, there is always some risk of unexpected consequences, so doctors advise against their removal unless they are causing a patient serious problems.[4]
One of the available treatments is performed by a dermatologist, using a CO2 laser to vaporise the papules. This normally takes only a few minutes to perform.[5] It is simple and does not normally require a hospital stay; discomfort should be minimal and the expected recovery time is limited to a few days. Another procedure involves electrosurgery performed with a hyfrecator and should take less than an hour to perform.[16]
Both procedures should be out-patient procedures if no complications arise.
Myths and misunderstandings
Although it is not related to any pathological condition, hirsuties papillaris genitalis is occasionally mistaken for HPV warts.[17] Home remedies abound for "curing" it.[4]
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 permanent genital mutilation. Rapini et al. advise that, since dermatologists have safe, effective ways to remove them if desired, home remedies involving corrosive substances or self-surgery should be avoided, since they can permanently damage sexual functioning. They further state that removal should only be performed by a physician using proven medical techniques.[1]
See also
References
- ^ a b c Rapini, Ronald P.; Bolognia, Jean L.; Jorizzo, Joseph L. (2007). Dermatology: 2-Volume Set. St. Louis: Mosby. ISBN 1-4160-2999-0.
{{cite book}}: CS1 maint: multiple names: authors list (link) - ^ Hogewoning JA, Bleeker MC, van den Brule AJ, et al. Pearly penile papules: Still no reason for uneasiness. J Am Acad Dermatol 2003;49:50–4
- ^ Pearly penile papules regress in older patients and with circumcisionK Agha *, S Alderson BA *, S Samraj MRCP , A Cottam BM *, C Merry BM *, V Lee MRCP and R Patel FRCP, This version was published on 1 November 2009 Int J STD AIDS 2009;20:768-770 doi:10.1258/ijsa.2009.009190 © 2009 Royal Society of Medicine Press
- ^ a b c Oxford handbook of genitourinary medicine, HIV, and AIDS, Volume 13 by Richard Pattman, Michael Snow, Pauline Handy, Babiker Elawad
- ^ a b CO2 Laser Treats Pearly Penile Papules American Health & beauty Magazine, Dr. William Groff, Friday, July 10, 2009
- ^ Hill,W.C.O.Note on the male external genitalia of the chimpanzee. Proc.Zool.Soc. Lond. 116, 129–132 (1946)
- ^ Murakami,R. A histological study of the development of the penis of wild-type and androgen-insensitive mice. J. Anat. 153, 223–231 (1987)
- ^ Glicksman,JM and Freeman, RG. Pearly penile papules. A statistical study of incidence. Arch. Dermatol. 93:56-59 (1966)
- ^ Agrawal,SK et al. Pearly penile papules: a review. Int. J. Dermatology 43:199-201 (2004)
- ^ a b Penile spines versus pearly penile papules in humans
- ^ Genetic losses contribute to human features
- ^ Paleoanthropology, Genetics, and Evolution
- ^ Vestibular papillae of the vulva. Archives Dermatology 126: 1594-1598. Moyal-Barracco M et al. 1990
- ^ Colposcopy of the Vulva, Perineum and Anal Canal
- ^ http://www.nomorepapules.com/WhatisPPP.html
- ^ Wimpole Aesthetic Centre, London
- ^ Human papillomavirus, and vaccination by Dr Laura Pye. InnovAiT, Royal College of General Practitioners, 2009
- Flerguety J, Robert (March 2011)."Pearly Penile Papules"
- Sonnex C, Dockerty WG (1999). "Pearly penile papules: a common cause of concern". Int J STD AIDS. 10 (11): 726–7. doi:10.1258/0956462991913402. PMID 10563558.
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External links
- DermAtlas—information and images