Hirsuties coronae glandis

Hirsuties coronae glandis (also known as hirsutoid papillomas[1] and pearly penile papules; PPP)[1] are small protuberances that may form on the ridge of the glans of the human penis. They are a form of acral angiofibromas.[2] They are a normal anatomical variation in humans and are sometimes described as vestigial remnants of penile spines, sensitive features found in the same location in other primates. In species in which penile spines are expressed, as well as in humans who have them, the spines are thought to contribute to sexual pleasure and quicker orgasms.[3][4] It has been theorized that pearly penile papules stimulate the female vagina during sexual intercourse.[5] In addition, pearly penile papules secrete oil that moistens the glans of the penis.[6]

Hirsuties coronae glandis
Other nameshirsutoid papillomas, pearly penile papules
Glans penis with hirsuties papillaris glandis
SpecialtyDermatology

The papules appear as one or several rows of small, pearly or flesh-colored, smooth, dome-topped bumps situated circumferentially around the corona or sulcus of the glans. They may range in size from less than 1 mm to 3 mm.[7] As of 1999, different studies have produced estimates of incidence ranging from 8 to 48 percent of all men.[8] Studies suggest that it occurs more often on younger men and those who have not been circumcised.[9] One study found them in 33.3% of uncircumcised males and 7.1% of circumcised males.[8]

Pearly penile papules are sometimes mistakenly confused with a human papillomavirus (HPV) infection due to a perceived similarity in appearance.[10]

A similar expression, vestibular papillomatosis of the vulva or "hirsuties papillaris vulvae",[11] occurs in females and similarly can be misinterpreted as an HPV infection. Like hirsuties papillaris genitalis, it is a normal variation on human anatomy.[12]

Medical removal

Before and after treatment to remove pearly penile papules

While hirsuties papillaris genitalis poses no risk to a male's health, some men or their sexual partners may consider them aesthetically displeasing. There are several medical ways to remove them. Like any elective medical procedure, there is always some risk of unexpected consequences, so doctors advise against their removal unless they are causing a patient serious problems.[7]

One of the available treatments is performed by a dermatologist, using a CO2 laser to vaporise the papules. This normally takes only a few minutes to perform.[13] It is simple and does not normally require a hospital stay; discomfort should be minimal and the expected recovery time is one to two weeks. Another procedure involves electrosurgery performed with a hyfrecator and should take less than an hour to perform.[14]

Both procedures should be out-patient procedures if no complications arise.

Myths and misunderstandings

Although it is not related to any pathological condition, hirsuties papillaris genitalis is occasionally mistaken for HPV warts.[15] There are also home remedies for "curing" it, despite the fact that the papules are neither infectious nor detrimental to one's health and may have beneficial functions.[6][7] Some of the "home remedies" found on the Internet and elsewhere use mild ointments or creams to soften the papules, but others are physically dangerous techniques for papule removal which can result in permanent genital mutilation.[1]

Rapini et al. advise that, since dermatologists have safe, effective ways to remove the papules if desired, home remedies involving corrosive substances or self-surgery should be avoided, since they can permanently damage sexual functioning. Rapini et al. further state that removal should only be performed by a physician using proven medical techniques.[1]

See also

Notes

  1. Rapini RP, Bolognia JL, Jorizzo JL (2007). Dermatology: 2-Volume Set. St. Louis: Mosby. ISBN 1-4160-2999-0.
  2. Gan SD, Graber EM (May 2015). "Treatment of Pearly Penile Papules with Fractionated CO2 Laser". The Journal of Clinical and Aesthetic Dermatology. 8 (5): 50–2. PMC 4445897. PMID 26029336.
  3. Kumar P, Das A, Savant SS (2015). "Multiple Shiny Papules on the Shaft of the Penis". Indian Journal of Dermatology. 60 (3): 325. doi:10.4103/0019-5154.156491. PMC 4458986. PMID 26120199.
  4. "The real "junk" DNA". john hawks weblog.
  5. Goovaerts HG, Koning G, Schneider H (January 1975). "A programmable stimulator for physiological applications". Medical & Biological Engineering. 13 (1): 112–8. PMID 1195791.
  6. French K (9 November 2009). Sexual Health. John Wiley & Sons. p. 31. ISBN 9781444322576.
  7. Pattman R, Snow M, Handy P, Elawad B. Oxford handbook of genitourinary medicine, HIV, and AIDS. 13.
  8. Brown CW (February 13, 2014). "Pearly Penile Papules: Epidemiology". Medscape. Retrieved 2014-03-08.
  9. Hogewoning CJ, Bleeker MC, van den Brule AJ, Voorhorst FJ, van Andel RE, Risse EK, Starink TM, Meijer CJ (July 2003). "Pearly penile papules: still no reason for uneasiness". Journal of the American Academy of Dermatology. 49 (1): 50–4. doi:10.1067/mjd.2003.420. PMID 12833007.
  10. Li H (28 August 2015). Radiology of Infectious Diseases:. Springer. p. 405. ISBN 9789401798822.
  11. Moyal-Barracco M, Leibowitch M, Orth G (December 1990). "Vestibular papillae of the vulva. Lack of evidence for human papillomavirus etiology". Archives of Dermatology. 126 (12): 1594–8. doi:10.1001/archderm.1990.01670360058008. PMID 2175164.
  12. Colposcopy of the Vulva, Perineum and Anal Canal.gyncph.dk
  13. Groff W (July 2009). "CO2 Laser Treats Pearly Penile Papules". American Health & beauty Magazine.
  14. "Pearly Penile Papules Removal". pearlypenilepapules.co.uk.
  15. Pye, Laura (2009), "Human papillomaviruse and vaccination", InnovAiT, Royal College of General Practitioners

References

  • Sonnex C, Dockerty WG (November 1999). "Pearly penile papules: a common cause of concern". International Journal of STD & AIDS. 10 (11): 726–7. doi:10.1258/0956462991913402. PMID 10563558.
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