brand logo

Am Fam Physician. 1998;57(7):1639-1640

A 24-year-old black man presented with painless small nodules on the penis (see the accompanying figure). He was referred for evaluation by his wife's physician because she had human papillomavirus infection, which had been identified through a Papanicolaou smear. The patient had no significant past medical history.

Question

What are the lesions that are seen in the photograph?

Discussion

The answer is D: pearly penile papules. Pearly penile papules1,2 are relatively common benign tumors that occasionally occur in uncircumcised males such as this patient (note that in the photograph, the foreskin was retracted for better visualization). Histologically, these angiofibromas are seen as regular projections from the edge of the glans at the coronal margin. Studies3 have shown that these angiofibromas do not contain HPV DNA by polymerase chain reaction; therefore, they are not condyloma acuminata. Nor are they condyloma lata, which are the moist condylomas seen in secondary syphilis. Reassurance is usually the only treatment necessary, but occasionally patients may request that the papules be removed. Treatment may consist of cryosurgery4 or laser therapy.5 This patient was reassured and discharged to routine follow-up.

The editors of AFP welcome submissions for Photo Quiz. Guidelines for preparing and submitting a Photo Quiz manuscript can be found in the Authors' Guide at https://www.aafp.org/afp/photoquizinfo. To be considered for publication, submissions must meet these guidelines. E-mail submissions to afpphoto@aafp.org.

This series is coordinated by John E. Delzell Jr., MD, MSPH, associate medical editor.

A collection of Photo Quiz published in AFP is available at https://www.aafp.org/afp/photoquiz

Continue Reading


More in AFP

More in Pubmed

Copyright © 1998 by the American Academy of Family Physicians.

This content is owned by the AAFP. A person viewing it online may make one printout of the material and may use that printout only for his or her personal, non-commercial reference. This material may not otherwise be downloaded, copied, printed, stored, transmitted or reproduced in any medium, whether now known or later invented, except as authorized in writing by the AAFP.  See https://www.aafp.org/about/this-site/permissions.html for copyright questions and/or permission requests.