Pearly rash on penis

Male genital pearly papules, also known as pearly male genital papules, male genital hairy papillomas, coronal sulcus or glans penis papules, are also called hairy male genitals or multi-papillary male genitals by scientists. At present, most people think that pearly papules on male genitals are a symptom and not a disease. This symptom is often seen in the outpatient clinics of STD hospitals, and is often easily misdiagnosed as genital warts.

1. Causes and prevalence of disease

The causes and prevalence of pearly papules on male genitalia are not clear at a glance. Some experts believe that this symptom is a physiological growth and development abnormality. Some scientists believe that it is related to the long foreskin. For example, research by Hu Xiao and others found that among young men, the prevalence of pearly papules on the male genitals of those with long foreskin was significantly higher than that of those with normal foreskin. Some experts believe that this symptom may be related to HPV infection, but Ferenczy et al. and Shankaijin et al. tested the HPV in the diseased tissue and found that there was no HPV. Observation shows that inflammatory symptoms such as the patient's long foreskin, poor local hygiene, long-term irritation of coronal sulcus and stains, or local swelling caused by other factors such as infection, may be the direct cause of this symptom.

2.Clinical symptoms

Pearly papules on male genitals are common in men aged around 20-30 years old. The damage mainly occurs at the intersection of the edge of the glans penis and the coronal sulcus and/or the frenulum of the penis. The risk is papules of 1-3mm size, which are very harmful if they are located on both sides of the frenulum of the penis. The tops of the papules are round and smooth, and some papules are hairy or flocculent. The papules are often combined with each other and arranged in several rows. They are prominent between the glans of the penis and can partially or completely surround the glans of the penis. The harmful color is mostly pearly white, a few are dark red, skin color, and some may have slight swelling. There is no tenderness, no ulceration, and the patient has no active symptoms.

3.Tissue pathophysiological examination

The pathological examination of male genital pearly papules mainly shows hyperkeratinization, moderate and severe hyperplasia of the outer layer, normal dermis, slight proliferation and high density of fibroblasts in the dermis, varying degrees of proliferation and expansion of dermal papillary capillaries, and a small amount of reticulocyte infiltration in the periphery, without hollow somatic cells.

4. Diagnosis key points

The key point in diagnosing male genital pearly papules and condyloma acuminata is that the former type of damage is limited to the edge of the glans of the penis. The damage is larger in number and is pearly milk-white papules with a smooth surface. The damage does not expand with the increase of the disease history, and the glacial acetic acid test is negative. The latter kind of lesions are not localized on the edge of the glans of the penis. They are mostly scattered alone and have great damage. The surface is uneven and mostly appear as cauliflower-like growths. They gradually expand with the increase of the disease history. The glacial acetic acid test is positive, and histopathological examination shows hollow somatic cells.