PEARLY PENILE PAPULES (PPP'S)

Pearly penile papules (PPP’s) are small raised nodules usually 1-2 mm in size located circumferentially on the coronal sulcus of the glans penis. They can be white or flesh-coloured, dome-shaped or finger-like. A normal anatomical variant which usually appear during adolescence, they have been reported in up to 35% of males. Most commonly they are confused with genital warts, but there is no known link to human papilloma virus. Penile papules appear to be without functional significance – they are NOT spread through sexual activity and they have NO malignant potential. Most men with PPP’s do not seek treatment. Some, however, feel that the papules are unattractive or that they give the impression that they have warts.

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Many treatment methods are offered for PPP removal, including circumcision, podophyllin, electrodessication and curettage, cryotherapy, and even the  application of a variety of acids, ointments, and potions. Both use and misuse of these methods can cause scarring. Unfortunately, a number of myths have made their way onto some normally quite accurate and sensible websites.  

Fordyce spots, collections of sebaceous glands with keratin plugs, are often to be found on the skin of the shaft of the penis.  Again, these are quite normal, but again cause concern because of their appearance.  Formal excision of the individual lesions usually gives the best results.

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There are occasional reports in the literature of the growth of further papules many years later.