Pearly penile papules PPP removal is achieved through the use of a CO2 carbon dioxide laser, an instrument that is commonly used for non-surgical skin resurfacing treatments. The laser is concentrated exclusively on the papules, ensuring that no damage is inflicted upon the penis. A topical anaesthetic is applied to the treated area, avoiding the need for injections, while ensuring that the procedure is completely painless. The treated skin does produce scabrous tissue following the procedure, but this is only temporary and heals within 1 to 2 weeks. Some minor swelling will occur and there will be some bleeding immediately following the treatment.
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Pearly penile papules PPP are common, benign lesions that appear on the corona of the glans penis during adolescence or early adulthood. Despite their benign nature, PPP are known to cause significant distress because of their resemblance to sexually transmitted infections such as condyloma acuminata. PPP can be clinically distinguished based on their uniform, dome-shaped papules that orient in one to two rows around the glans penis.
There is no association between PPP and sexually transmitted infections, and treatment is generally reserved for patients with excessive concern. Physicians should be aware of this distinction in order to adequately reassure anxious patients. For patients who still desire treatment after counseling, cryotherapy and laser therapy represent two reliable treatment options with low rates of recurrence.
Pearly penile papules PPP are painless and benign lesions that present in rows around the corona of the glans penis in late adolescence or early adulthood. Although asymptomatic, they are often mistaken for sexually transmitted infections such as condyloma acuminata Oates, Johnson and Baxter were the first to coin the term PPP in The lesions usually present as pink or white, dome-shaped or filiform papules that are one to two millimeters in diameter and one to four millimeters in height, orienting around the corona of the glans penis usually in one to two rows Figure 1 ; Agrawal et al.
The prevalence declines in older patients, suggesting that the lesions regress with age Agha et al. Circumcised males have lower rates of PPP, possibly due to chronic abrasion to the exposed corona causing lesion regression Agha et al. Unfamiliarity of the benign nature of PPP often leads to significant anxiety and fear of having a sexually transmitted infection. This misconception can also lead to strained relationships, as fear of a possible sexually transmitted infection calls into question the fidelity between partners Monroe, The degree of concern has even been correlated to the size of the papules.
Molluscum contagiosum can be distinguished clinically from PPP based on their umbilicated papules that are larger in size Agrawal et al. This vessel architecture is nonspecific and can also be seen in condyloma Watanabe et al. Unlike warts, however, PPP do not have desquamation, which is seen as an irregular reflection on dermoscopy Ozeki et al.
The histology of PPP is similar to that of acral angiofibromas, and for this reason they have been proposed as a subcategory Oates, ; Ozeki et al. Increased vasculature is seen in the upper dermis with focally elongated rete ridges Oates, ; Ozeki et al. The dermis also contains infiltration of lymphocytes and histiocytes Oates, ; Ozeki et al.
Because of the benign nature of PPP as well as their regression with age, treatment is generally reserved for patients who suffer extensive embarrassment or concern. Cryotherapy and lasers have been reported in such cases. The high vascularity of penile tissue allows for rapid healing after laser-induced thermal injury, but this also predisposes the patient to bleeding during the procedure.
While the CO 2 laser exposes the underlying tissue, reepithelialization generally occurs within 5 to 7 days Krakowski et al. Nevertheless, the procedure requires anesthesia and increases the risk of scarring and infection. The CO 2 laser can also lead to postinflammatory pigmentation changes in dark skin types. All lesions were successfully cleared with no adverse effects and no recurrence after 1 year.
Notably, many of the patients in this study had prior failed treatment attempts with agents such as podophyllin, cryotherapy, and topical fluorouracil plus salicylic acid. Ablated areas healed within 2 weeks after treatment. Despite sustaining up to six laser sessions, no scarring or pigmentation changes were noted Baumgartner, Fractional resurfacing with the nm erbium laser has shown complete clearance in one patient after five treatment sessions.
Unlike ablative approaches, this laser was relatively painless and did not produce open wounds in the skin. The pulsed dye laser has also shown significant lesion clearance with minimal discomfort. In a study involving four patients, Sapra, Sapra, and Singh achieved complete resolution in three patients after two to three treatments.
The remaining patient was satisfied with the results after one treatment. Future laser therapies will likely focus on nonablative approaches, such as the pulsed dye laser, to adequately and painlessly treat PPP without the risk of infection or scarring.
Although typically reserved for special scenarios, laser treatment of PPP produces favorable cosmetic results with a low risk of adverse effects and recurrence. PPP are common, asymptomatic lesions that can cause serious concern for patients despite their benign nature.
The fear of sexually transmitted infections can cause significant distress in male and female patients alike, severely affecting quality of life. Understandably, a new or recently discovered genital lesion can send patients running to their doctors. While frequent misdiagnosis of benign lesions such as PPP perpetuates patient anxiety, these lesions can be both clinically and histologically distinguished from more serious conditions such as condyloma acuminata.
Reassurance is the most appropriate course of action, although treatment options such as laser and cryotherapy are available for patients with significant distress. It is important for physicians to be aware of this common mimicker in order to provide appropriate management. National Center for Biotechnology Information , U. Am J Mens Health. Published online Jun Adam S. Aldahan , BS, 1 Tara K.
Tara K. Author information Copyright and License information Disclaimer. Email: ude. This article has been cited by other articles in PMC. Abstract Pearly penile papules PPP are common, benign lesions that appear on the corona of the glans penis during adolescence or early adulthood. Introduction Pearly penile papules PPP are painless and benign lesions that present in rows around the corona of the glans penis in late adolescence or early adulthood.
Open in a separate window. Figure 1. Treatment Because of the benign nature of PPP as well as their regression with age, treatment is generally reserved for patients who suffer extensive embarrassment or concern.
Conclusion PPP are common, asymptomatic lesions that can cause serious concern for patients despite their benign nature. References Ackerman A. Pearly penile papules.
Acral angiofibromas. Archives of Dermatology , , Pearly penile papules regress in older patients and with circumcision. Pearly penile papules: A review. International Journal of Dermatology , 43 , Erbium: yttrium-aluminium-garnet Er:YAG laser treatment of penile pearly papules.
Journal of Cosmetic and Laser Therapy , 14 , The nonvenereal diseases of the genitals: Etiology, differential diagnosis, and therapy. Springfield, IL: Thomas. Pearly penile papules: Absence of human papillomavirus DNA by the polymerase chain reaction. Treatment of pearly penile papules with fractionated CO 2 laser.
Journal of Clinical and Aesthetic Dermatology , 8 5 , A statistical study of incidence. Archives of Dermatology , 93 , Meijer C.
Pearly penile papules: Still no reason for uneasiness. Journal of the American Academy of Dermatology , 49 , Archives of Dermatology , 90 , Common genital dermatoses in male patients attending a public sexually transmitted disease clinic in Singapore.
Annals of the Academy of Medicine, Singapore , 24 , Successful treatment of pearly penile papules with carbon dioxide laser resurfacing after local anesthesia in an adolescent patient. Pediatric Dermatology , 32 , Treatment of pearly penile papules with CO 2 laser. Dermatologic Surgery , 28 , Pearly penile papules: Treatment with the carbon dioxide laser. Journal of Dermatologic Surgery and Oncology , 15 , The clinical superiority of continuous exposure versus short-pulsed carbon dioxide laser exposures for the treatment of pearly penile papules.
Dermatologic Surgery , 25 , Normal variants in patients consulted in the dermatology clinic for lesions of the male external genitalia. Central European Journal of Urology , 65 1 , Does this man have genital warts? Journal of the American Academy of Physician Assistants , 22 2 , Pink pearly papules: An epidemiologic study.
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Pearly Penile Papules
Had rough bumps around your penis for the longest time? They are usually arranged circumferentially and they have the same colour as your skin. Pearly penile papules are actually a normal variant of the penile anatomy. Although they are often mistaken as sexually transmitted lesions. These bumps are present since young. They are not a disease, cancer risks or abnormality.
Pearly Penile Papules Removal in Singapore
Pearly penile papules, also known as papillomatosis corona penis, corona capillitii, hirsuties coronae glandis, papillae coronis glandis, and hirsutoid papillomas, are benign lesions of the penis. Pearly penile papules are considered normal anatomical variant. They are rarely observed in children and mainly seen in late adolescence and early adulthood. Their prevalence declines in older patients as the lesions involute with aging. Similar papules have never been described on female genitalia.
What Are Pearly Penile Papules?
Objective: Pearly penile papules are asymptomatic, benign growths distributed around the corona of the penis that can frequently be a source of significant psychological distress for the patient. Various treatment options are limited mainly by their complications. Design: Two case reports and a review of the literature. Setting: University academic setting. Participants: Two subjects of skin types I and V.