International Journal of STD & AIDS > Volume 20, Number 11 > Pp. 768-770

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Original research articles

Pearly penile papules regress in older patients and with circumcision

K Agha ^*, S Alderson BA ^*, S Samraj MRCP , A Cottam BM ^*, C Merry BM ^*, V Lee MRCP  and R Patel FRCP  

^* University of Southampton, Southampton General Hospital, Tremona Road, Southampton SO16 6YD; Department of GUM and HIV, University of Southampton, Royal South Hants Hospital, St Mary's Road, Southampton SO14 OYG, Hampshire, UK

Correspondence to: Dr R Patel, Department of GUM and HIV, Royal South Hants Hospital, St Mary's Road, Southampton SO14 OYG, UK Emails: prj466{at}aol.com; km804{at}soton.ac.uk

This study assesses the prevalence and correlates of pearly penile papules (PPP) in two non-genitourinary (GU) medicine male cohorts (<25 and >50 years). PPP were categorised in 188 university students (<25 years), based on self-examination, and 70 patients (>50 years), based on clinician examination. PPP were categorised from 1 to 4, based on increasing papule size and distribution. An anonymous questionnaire was used to identify associations with PPP prevalence. The prevalence of PPP was 38.3% in <25 years, and 11.4% in >50 years (P < 0.001). The prevalence of categories 3 and 4 PPP was 8.5% in <25 years, and 1.4% in >50 years (P < 0.05). In the younger age group, the prevalence of PPP was 26.5% in circumcised participants, and 42.4% in uncircumcised participants (P < 0.05), but was unrelated to either frequency of sexual intercourse or time since first sexual intercourse. In conclusion, PPP disappear with age, and any PPP in patients >50 years are less marked than those in patients <25 years. Patients should be advised accordingly. PPP are less prevalent in circumcised men. Patients could be advised to wear the foreskin rolled back – this may maximize exposure of the coronal area to normal abrasion, which may hasten PPP regression.

Key Words: penile papules • circumcision

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