It’s pearly rash! Every man has it

What is pearly rash?

Penile pearly rash is found on the edge of the male glans. It is a papule the size of a millet grain that is uniformly arranged in the same skin color and has no inflammatory reaction or any conscious discomfort. This is pearly rash. If you do The acetic acid whitening test is negative, that is, it does not turn white after applying 5% acetic acid solution. This condition is seen in men after puberty. It is a completely normal phenomenon and does not require treatment. There is no need to panic. However, in some places, this phenomenon is mistaken for genital warts. It is wrong to undergo laser treatment and take medication at the same time.

Pearl-shaped papules are not sexually transmitted diseases★★★

〔Reposted from: Original clicks on this site: 347 Update time: 2004-12-20〕

When the joy of the wedding night was about to enter the fighting stage, the bride was suddenly surprised to find a circle of small protrusions on the groom's penis. As a result, the burning desire was extinguished as if a basin of ice water was poured on it. The doctor explained that this was not a sexually transmitted disease, but pearly papules on the penis that men would see.

Penile pearly papules are a physiological developmental variation of the human body. They are not harmful to the human body and are not contagious. Treatment is not required. About 24% of adult men have penile pearly papules, which are usually some pearly, red, yellow or white translucent papules. The diameter of a single papule is about 1 to 3 mm, arranged in one to several rows along the coronal sulcus, and sometimes surrounding it. Throughout the coronal sulcus, the papules are often arranged neatly and do not merge with each other; condyloma acuminata, in addition to often occurring on the glans and coronal sulcus, can also occur on the inside of the foreskin, the skin of the penis body, the urethral opening, the anus and the perianal junction, and the warts The number is small, and most of them are cauliflower-shaped, papillary or corona-like wart-like hyperplasia. This is different from the neatly arranged pearly papules that only occur in the coronal groove of the glans penis.

In women, it is called pseudocondyloma. It only occurs on the inner side of the labia minora and the vaginal vestibule. It is often arranged in a turtle egg shape from top to bottom and symmetrical on both sides. It generally does not continue to grow, and occasionally it can Slowly enlarge, the rashes do not merge with each other, and there is no purulent secretion or foul odor; while female genital warts can occur in the vulva labia, vaginal opening, vaginal mucosa, urethral opening and cervix, anus and perianal junction, etc. The warts are symmetrical and vary in size, and often continue to enlarge into cauliflower-like, comb-like or papillary shapes. They can also merge with each other and often have purulent secretions and stench.

Although penile pearly papules and pseudocondyloma are somewhat similar to condyloma acuminata, penile pearly papules or pseudocondyloma are often asymptomatic, so they often go unnoticed, and when these papules begin to develop There it is. In addition, people don’t know much about sexually transmitted diseases, and they don’t understand the difference between papules and genital warts. The latter has an incubation period, usually 3 weeks to 8 months after infection (such as sexual intercourse with a woman with sexually transmitted diseases), with an average of 2 to 3 The onset of the disease is months later, and it is unlikely to occur immediately after sexual intercourse. In this way, some people panic when they find abnormalities in their genitals and do not go to regular hospitals for diagnosis and treatment. As a result, the upstream doctors are often wrong and there is no need for treatment. Instead, they not only lose money, but also treat the non-disease into a disease.

Clinically, many skin lesions or diseases that occur on the vulva and anus of men and women have some similarities with genital warts. They are often misdiagnosed as genital warts, causing great harm to patients. mental stress and panic, thus affecting normal study and work, the relationship between husband and wife and the normal life of the family. If coupled with incorrect treatment, it will cause damage and pain to the patient's physical and mental health, as well as significant economic losses to the patient. The most common lesions or diseases that are misdiagnosed as genital warts are vulvar pseudocondyloma and male penile pearly papules. Misdiagnosis of these conditions as genital warts may not only be clinical but also histopathological. For example, Chen Lezhen et al. re-evaluated 321 specimens that had been pathologically diagnosed as genital warts and found that 62.9% of them were pseudocondyloma. %. The main reasons for the misdiagnosis of genital warts are the atypical clinical manifestations of genital warts or the difficulty in diagnosing genital warts in some atypical lesions, as well as the insufficient understanding of genital warts and/or certain lesions by clinicians. This section introduces some conditions that may be misdiagnosed as genital warts.

Penile pearly papules are also known as pearly penile papules, penile hairy papillomas, coronal sulcus or glans papules, and are also called hairy penis or multi-papillary penis by some scholars. At present, it is mostly believed that the appearance of pearly penis ≈ ⅲ?⒎ And Hui Zhishi 8≈⒃?a href= class=key> is often seen in sexually transmitted disease clinics, and is often easily misdiagnosed as genital warts.

1. Cause and incidence

The cause and incidence of pearly papules on the penis are not yet clear. Some scholars believe that this disease is an abnormality of physiological development. Some scholars also believe that it is related to the excessive foreskin. For example, a survey by Chen Xue and others found that the incidence of pearly papules on the penis of young men with excessive foreskin was significantly higher than that of those with normal foreskin. Some scholars believe that this disease may be related to HPV infection, but Ferenczy et al. and Kaikai Jin et al. detected HPV in the diseased tissue and found no HPV. The author observed that inflammatory reactions such as excessive foreskin, poor local hygiene, long-term stimulation of coronary sulcus secretions and dirt, or local redness and swelling caused by other factors such as infection may be the direct cause of this disease.

The incidence of penile pearly papules varies among reports.

Foreign reports indicate that this disease is present in 8.3%-30.1% of the normal male population. A domestic survey by Chen Fenggang and others found 159 cases among 239 men (excluding patients with phimosis and sexually transmitted diseases), with an incidence rate of 66.53%. Zhang Kaijin et al. found 220 cases among 917 cases, with an incidence rate of 24%. Chen Xue et al. found 786 cases among 2,037 male young people who underwent premarital physical examination, with an incidence rate of 37.92%. The author investigated 276 cases in STD clinics and found 109 cases, with an incidence rate of 39.49%. These findings indicate that penile pearly papules are a common clinical condition.

2. Clinical manifestations

Pearly penile papules are more common in men aged around 20-30 years old. Damage mainly occurs at the junction of the edge of the glans penis and the coronal sulcus and/or at the frenulum. The lesions are papules with a size of 1-3 mm, and the lesions are larger on both sides of the frenulum. The top of the papules is round and smooth, and some papules are hairy or filamentous. Most of the papules do not merge with each other and are densely arranged in one or more rows. They are obvious on the dorsal side of the glans and can partially or completely surround the glans. The color of the damage is mostly pearly white, a few are light red, skin color, and some may have mild redness and swelling. There was no tenderness or ulceration, and the patient had no subjective symptoms.

3. Histopathological examination

The histopathological examination of penile pearly papules shows hyperkeratosis, mild to moderate epidermal hyperplasia, normal basal layer, and slight collagen fibers in the dermis. There is hyperplasia and density, and the capillaries of the dermal papilla are proliferated and expanded to varying degrees, with a small amount of lymphocyte infiltration around, but no hollow cells.

4. Key points of differential diagnosis

The key points of differential diagnosis of penile pearly papules and condylomata acuminata are that the damage of the former is limited to the edge of the glans, and there are more lesions, which are pearly milky white papules on the surface. Smooth, the damage does not increase as the course of the disease prolongs, and the acetic acid test is negative; while the damage of the latter is not limited to the edge of the glans, but is mostly scattered, the damage is larger, the surface is not smooth, and it is mostly cauliflower-shaped, and it gradually increases as the course of the disease prolongs, and the acetic acid test is negative. The test was positive, and histopathological examination showed hollow cells.

5. Treatment principles

Penile pearly papules are a benign condition. Some people will subside after a certain period of time, and some people will last for decades without change. Since the disease is not contagious and does not harm health, no treatment is required. However, in order to prevent the disease from getting worse, it is very important for patients to pay attention to local hygiene and maintain a dry environment. If the patient requires treatment, laser therapy, cryotherapy or external application of corrosive drugs can be used to remove it, but remember to avoid excessive damage that may cause scarring and cause pain to the patient. In some patients, the lesions may recur after removal.

Penis curvature Penis curvature Penis curvature

A normal male penis is composed of two left and right corpus cavernosum, urethra and urethral corpus cavernosum. When sexual desire is high, the cavernous body becomes congested with blood and the penis becomes erect. For people with penile curvature, the penis often cannot erect normally when sexual desire comes, thus affecting sexual function. At the same time, the urethral opening of such patients moves backward and their clothes and pants are often wet when urinating, which brings great inconvenience to their lives and must be treated.

However, the key for people with penis curvature is to find out the cause so that targeted treatment can be provided. Clinical studies have shown that the most common diseases causing penile curvature in men are hypospadias and Peyronie's disease (or chronic cavernositis), which should be diagnosed for treatment.

Hypospadias is a congenital malformation that sometimes occurs in a family for several generations. In patients with mild hypospadias, the urethra opens in the coronal groove of the penis, and the penis itself is not curved or is slightly curved. It is often ignored by parents in childhood and does not affect sexual function when growing up, so no treatment is needed. In severe hypospadias, the urethral opening can be at the junction of the penis and the scrotum, or even in the perineum in some cases. The defective urethra is replaced by a fibrous band. The penis is short and flat, with obvious or severe downward curvature. Sexual intercourse cannot be achieved in adulthood. At the same time, because the urethral opening is past the opening and ejaculation is outside the vagina, it is infertile and must be surgically corrected.

The operation is generally performed in two stages. The first stage is best performed when around two years old, mainly to cut off the cord to straighten the penis; the second stage is performed half a year to one year after the first stage. Wait until the local scar tissue softens before proceeding, mainly to perform urethroplasty. When you grow up, the curvature of your penis becomes difficult to correct. Of course, some people in the medical field advocate completing the two-stage operation in one, that is, while removing the penile cord to straighten the curved penis, a leather tube is used to make the bladder mucosa into a tube to replace the defective urethra.

Most patients with Peyronie's disease are middle-aged. The main symptom is the hyperplasia of connective tissue in the penis. There are one or several hard plaques and strips on the back of the penis. When the penis is erect, it bends upward or left and right with slight pain. If the bending is obvious, it will affect sexual life. The cause of the disease is unknown, but injury and inflammation may be predisposing factors. Surgery to remove induration is easy to recur, so it is not recommended. The general treatment is local injection of cortisone into the induration or cord, and oral vitamin E at the same time. Penile histamine or iodine iontophoresis can also be done with the cooperation of the physical therapy department, but in general, the treatment effect is not ideal.

There are two situations that lead to penis curvature: one is curvature in the front and back direction; the other is curvature in the left and right direction. No matter what kind of curvature, the factors are nothing more than three aspects: physiological, congenital, and pathological.

Physiological penis curvature generally has no impact on sexual life. Because penile erection is achieved by congestion of the corpus cavernosum, the corpus cavernosum is not one, but consists of three round, long columnar corpus cavernosum. These three cavernous bodies are like sponges, with many cavities inside that are connected to blood vessels. The two cavernous bodies on the upper part of the penis are called the corpus cavernosum, and the lower one is called the corpora cavernosa of the urethra, through which the urethra passes. When the cavities within the cavernous body become congested with blood, the penis becomes thicker and harder. If the three cavernous bodies are equal in size after congestion, that is, the penis has a normal erection; if the three cavernous bodies are different in size after congestion, the penis will bend in the direction of less congestion. In fact, most men's penises are somewhat curved to varying degrees when erect.

However, the curvature of the penis in some men is caused by congenital abnormalities of the reproductive organs. For example, congenital hypospadias can cause the penis to bend ventrally, and even lead to underdevelopment of the reproductive organs, causing obstacles to sexual life and fertility. There are more patients with congenital epispadias, and the superior fissure has a greater impact on the penis than the inferior fissure. More serious. Patients with epispadias have a short penis that curves dorsally during erection, making intercourse difficult or impossible. At this time, you should go to the urology department of the hospital for examination and surgical correction.

Pathological curvature of the penis refers to the penile curvature caused by trauma or infection, which results in local scarring; or the curvature of the penis caused by excessive removal of the foreskin during circumcision surgery. If you suffer from fibrous cavernitis, there will be one or several fibrous indurations on the back of the penis, which can lead to penile curvature and even painful erection. Surgical correction can be performed on patients with improper circumcision, and penile curvature caused by fibrous spongiosum can also be treated surgically.