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Pearly penile papules

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Glans penis with Hirsuties papillaris penis
Hirsuties papillaris coronae glandis enlarged
Hirsuties papillaris coronae glandis macro

Hirsuties papillaris genitalis (more commonly referred to as "pearly penile papules", or PPP) is a clinical skin condition of the male genital organs. It is a harmless physiological phenomenon with no malignant potential, although it can be mistaken for warts by inexperienced doctors. The papules appear as one or several rows of small, flesh-colored, smooth, dome-topped bumps situated circumferentially around the corona (see image) or sulcus of the glans penis. Uncommonly, lesions may extend onto the glans penis. It is not a sexually transmitted disease and its appearance is unrelated to sexual activity or standards of personal hygiene. The bumps are however extremely sensitive and many sufferers view this sensitivity as unwelcome. [1] A 1999 medical study found that 48% of 200 men attending a department of genitourinary medicine had the condition. Various other studies have shown that the number may be in the interval between 8% and 48%, varying with region and whether or not the subjects are circumcised. Lesions typically are asymptomatic and persist throughout life; however, they gradually may become less noticeable with increased age.

A similar condition - Vestibular papillae of the Vulva occurs in females, and similarly can be misinterpreted for HPV infection; again, this is not a sexually transmitted disease, but a normal variation on human anatomy. [2].

It is possible that the papules are related to the penile spines which occur in other mammals - including primates, such as marmosets [3]. In cats, these spines trigger female ovulation. In other mammals they may perform a sensory function, and research has shown that the increased sensory stimulation they provide may increase the chance of successful mating. [4]. The spines (and in the case of humans, the pearly penile papules) may also aide in the eviction of foreign sperm [5] when a female mates with multiple males by acting as a brush, and thus increasing the likelihood of fertilization by the copulating male.

An informal survey of a number of internet forums relating to the topic indicates that both vulvar vestibular papillae and pearly penile pappilae can increase sensation and pleasure due to the increased tactile sensation and friction.

Treatment

Therapy is not required but sometimes offered to alleviate patient anxiety or for cosmetic reasons. Treatment for larger uncomfortable papules — i.e. raised bumps of somewhat paler colour around the base of the glans — is by a simple carbon dioxide laser treatment.

Further reading

  • Sonnex C, & Dockerty W.G (1999). "Pearly penile papules: a common cause of concern". International Journal of STD & AIDS, Vol.10, No.11; 1 November 1999, pages 726-727.