Hirsuties papillaris genitalis

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 anatomical variation 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 some argue its appearance is related to sexual activity but not standards of personal hygiene. The bumps are however extremely sensitive and many sufferers view this sensitivity as unwelcome. [EMedicine|derm|313|Pearly Penile Papules] 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. [ [http://www.gyncph.dk/procedur/ref/gyn/vulvoscopi_chapter14_eagc.pdf Colposcopy of the Vulva, Perineum and Anal Canal] ]

It is possible that the papules are related to the penile spines which occur in other mammals - including primates, such as marmosets [cite journal |author=Dixson AF |title=Penile spines affect copulatory behaviour in a primate (Callithrix jacchus) |journal=Physiol. Behav. |volume=49 |issue=3 |pages=557–62 |year=1991 |month=Mar |pmid=2062934 |doi= |url=http://linkinghub.elsevier.com/retrieve/pii/0031-9384(91)90280-2] . A paper published in September 2000 by Gibbs, Collard and Wood on Soft Tissue Characters in Higher Primate Phylogenetics [cite journal |author=Gibbs S, Collard M, Wood B |title=Soft-tissue characters in higher primate phylogenetics |journal=Proc. Natl. Acad. Sci. U.S.A. |volume=97 |issue=20 |pages=11130–2 |year=2000 |month=Sep |pmid=10995466 |pmc=27160 |doi=10.1073/pnas.190252697 |url=] describes penile spines 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. [cite journal |author=Stockley P |title=Sperm competition risk and male genital anatomy: comparative evidence for reduced duration of female sexual receptivity in primates with penile spines |journal=Evolutionary Ecology |volume=16 |issue=2 |pages=123–37 |year=2002 |url=http://www.ingentaconnect.com/content/klu/evec/2002/00000016/00000002/00406968?token=003511b04383a4b3b257b6e7b6d24316a53354966472a72752d7b] . The spines (and in the case of humans, the pearly penile papules) may also aide in the eviction of foreign sperm [cite web |url=http://news.bbc.co.uk/2/hi/health/3128753.stm |title=Health: Penis is a competitive beast |format= |work=BBC NEWS |accessdate=] when a female mates with multiple males by acting as a brush, and thus increasing the likelihood of fertilization by the copulating male.

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.

References

*cite journal |author=Sonnex C, Dockerty WG |title=Pearly penile papules: a common cause of concern |journal=Int J STD AIDS |volume=10 |issue=11 |pages=726–7 |year=1999 |month=Nov |pmid=10563558 |doi= |url=http://ijsa.rsmjournals.com/cgi/pmidlookup?view=long&pmid=10563558

External links

* [http://www.hpvfaq.com/answers.asp?questionid=10814&answers=160 HPVFAQ.com] —discussion about PPP
* [http://dermatlas.med.jhmi.edu/derm/result.cfm?Diagnosis=57 DermAtlas] —more images