Pearly Penile Papules (PPP)

Pearly penile papules (PPP) represent localized, skin-tag-like growths, consisting of blood vessels and fibroblasts (cells that produce the framework of the skin). PPP are harmless lesions that do not turn into cancer, but may cause significant cosmetic concern. They are found in up to 30% males after teenage years, and are more commonly seen on uncirucmcised penises. Unlike genital warts (condyloma), PPP are not associated with sexually transmitted viruses or sexual activity.

Presentation:
PPP are 1-3 mm, dome-shaped, skin-colored bumps, arranged in one or two circumferential rows at the base of the penile head (also known as the corona). Occasionally, PPP may involve the entire head of the penis.

Treatment:
Since PPP are benign, no treatment is warranted unless the lesions are causing discomfort or cosmetic concern. Treatment options may include freezing with liquid nitrogen, electrodessication (the use of electric current to destroy skin tissue), podophyllin (a topical agent used to treat warts), and carbon-dioxide laser. Circumcision may also help to reduce the development of new lesions.

References:
Hogewoning C et al. Pearly penile papules: Still no reason for uneasiness. J Am Acad Dermatol 2003;49:50-4.
Kamino H and Pui J. “Fibrous and Fibrohistiocytic Proliferations of the Skin and Tendons.” Dermatology. Eds. Bolognia JL, Jorizzo JL, and Rapini, RP. Mosby:Edinburgh, 2003, 1863-81.
Ocampo-Candiani J and Cueva-Rodriguez JA. Cryosurgical treatment of pearly penile papules. J Am Acad Dermatol 1996;35:486-7.

Matthew Smetanick, D.O.
Department of Dermatology
Philadelphia College of Osteopathic Medicine/Frankford Hospital
Philadelphia, Pennsylvannia.