Identifying White Bumps: Warts or Pearly Penile Papules?

It is unclear whether it is cauliflower (condyloma acuminatum) or a pilar cyst?

Hello Doctor: Today I noticed white papules near the frenulum of the glans (attached image).
I'm unsure if they are warts (condyloma acuminatum) or pearly penile papules.
Could you please help clarify? The image can be found at the following link: http://imgur.com/a/rkedz.
Thank you for your response!

Xiao Ye, 20~29 year old female. Ask Date: 2016/10/05

Dr. Sun Hongshun reply Urology

Hello, it doesn't look much like cauliflower, but there is localized redness and swelling.
It is recommended to consult a dermatologist for treatment.
Wishing you good health.

Reply Date: 2016/10/05

More Info

When it comes to identifying white bumps on the penis, particularly around the frenulum (the band of tissue on the underside of the penis), it is essential to differentiate between various conditions, such as pearly penile papules and genital warts (condylomata acuminata).
Pearly penile papules are small, dome-shaped, white or flesh-colored bumps that typically appear in rows around the corona of the glans (the head of the penis). They are a normal anatomical variant and are not associated with any disease or infection. These papules are harmless and do not require treatment unless they cause psychological distress to the individual.

On the other hand, genital warts are caused by certain strains of the human papillomavirus (HPV). They can appear as small, flesh-colored or white bumps that may be raised or flat, and they can sometimes cluster together to form a cauliflower-like appearance. Genital warts are sexually transmitted and can be associated with other health risks, including an increased risk of certain types of cancer.

To accurately assess the nature of the white bumps you are observing, consider the following factors:
1. Appearance: Pearly penile papules are typically uniform in size and shape, while genital warts may vary in size and can have an irregular surface.

2. Location: Pearly penile papules are usually found around the corona of the glans, whereas genital warts can appear anywhere on the genital area, including the shaft of the penis, scrotum, and surrounding skin.

3. Symptoms: Pearly penile papules are asymptomatic and do not cause discomfort. In contrast, genital warts may be itchy, painful, or cause discomfort during sexual activity.

4. History of Sexual Activity: If you have had unprotected sexual contact with multiple partners, the risk of HPV infection increases, which could lead to the development of genital warts.

Given the potential implications of genital warts, it is advisable to consult a healthcare professional for a thorough examination and accurate diagnosis. A dermatologist or urologist can provide a definitive diagnosis through visual inspection and, if necessary, further testing.
If it is determined that the bumps are indeed genital warts, treatment options are available, including topical treatments, cryotherapy (freezing), laser therapy, or surgical removal. It is also important to discuss HPV vaccination, which can help prevent certain strains of the virus that cause genital warts and cervical cancer.

In conclusion, while pearly penile papules are a benign condition, genital warts require medical attention due to their infectious nature and potential health risks. If you have any concerns about the bumps you are experiencing, seeking medical advice is the best course of action to ensure your health and peace of mind.

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