Nacreous papules

Description:

In the standard opinion nacreous papules of a penis (Pearly penile papules), pearl papules, a nacreous ring of a penis) are norm option, are not harmful to health, do not cause any complications, are not transferred at sexual contacts and are a cosmetic shortcoming.
Judging by numerous questions from patients in personal practical activities and on the Internet - to consultations it is the problem concerning many young people. It is not surprising - these rashes occur according to different authors at 30% of young men aged from 15 up to 30 years, in medical literature this question is taken up restrictedly and is very contradictory, many practicing doctors are unfamiliar with this problem, effective methods of treatment it is not offered.

Reason of nacreous papules:

The reason of emergence of nacreous (pearl) papules is finally not found out. One authors (Rufli T, Eichenberger P, Heer K.1978 of) consider that it is proliferation of an epithelium of output channels of microglands of a penis (coronae glandis), others consider them fibroplastic proliferation of certain sites of the epithelium covering a balanus.
In the statistical plan of PPPs come to light at black men more often - 44% netsirkumizirovanny ("not cut off") and 20,8% at tsirkumizirovanny ("cut off"), white men have these indicators respectively 33% and 7%. This statistics involuntarily suggests an idea of a smegma role - a secret of glands of a penis in emergence of proliferation of their output channels. Also the fact of emergence and heavy growth of papules during puberty and their disappearance or reduction of their quantity after its termination - i.e. by 24-25 years testifies to a role of the increased level of androgens in an organism.
Thus the following mechanism of emergence of PPPs is probable - the increased level of androgens causes the strengthened secretion of glands of a balanus and the increased allocation of a smegma which owing to the physical and chemical properties annoyingly influences an epithelium causing its fibroplastic proliferation (growth). Trimming minimizes this influence therefore the percent of persons with nacreous papules among them is lower, than at not cut off.

Symptoms of nacreous papules:

The main and only sign of nacreous papules of a penis is existence close located the identical size (usually several millimeters) dense, painless small knots  (papules) with brilliantly - an opaque surface, reminding pearls (from here and the name). In most cases they surround a balanus in the form of a ring (from here the name a nacreous ring) in one, in two and more rows.

Differential diagnosis:

It is necessary to distinguish nacreous papules from anogenitalny warts (sharp-pointed condylomas) caused by a human papillomavirus infection and a contagious mollusk.
Unlike nacreous papules sharp-pointed condylomas of the unequal size, soft, are located on thin "leg".
The contagious mollusk seldom is located in a coronal furrow, the size of rashes is not identical, pupkoobrazny impression in the center is characteristic and at expression from it curdled contents are allocated

Lechene of nacreous papules:

Treatment is not required. With the cosmetic purposes it can be carried out at the request of the patient. The carbonic laser, an eletrokoagulyation, cryotherapy are applicable. After removal a recurrence is in certain cases celebrated. Drugs of Podophyllinum and imikvimod are inefficient.