Hirsuties papillaris genitalis
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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]. A paper published in September 2000 by Gibbs, Collard and Wood on Soft Tissue Characters in Higher Primate Phylogenetics [4] ascribes penile spines as being present in Humans, Gorillas and Orangutans.
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. [5]. The spines (and in the case of humans, the pearly penile papules) may also aide in the eviction of foreign sperm [6] when a female mates with multiple males by acting as a brush, and thus increasing the likelihood of fertilization by the copulating male.
[edit] 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.
[edit] 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.
[edit] External links
- eMedicine—detailed explanation
- HPVFAQ.com—discussion about PPP
- DermAtlas—more images
