Pearly penile papules regress in older patients and with circumcision

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.