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Pearly Penile Papules — SCE Dermatology MCQ

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HardGenital DermatologyPearly Penile PapulesSCE Dermatology

A man referred from a sexual-health clinic has two orderly rows of 1–2 mm asymptomatic papules around the corona. Dermoscopy shows separate, uniform whitish-pink projections with central dotted or comma vessels. He requests cryotherapy because he fears HPV. What is the best response?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: D — Explain that these are pearly penile papules and offer reassurance rather than wart treatment

Explanation lettering: B = shown as A · D = shown as B · E = shown as C · A = shown as D · C = shown as E

A is correct. Pearly penile papules are a benign anatomical variant characterised by uniform papules in one or more circumferential rows around the corona. Their orderly distribution, separate bases and regular vascular pattern distinguish them from the irregular projections and shared bases of condylomata. They are neither infectious nor sexually transmitted, so reassurance is usually preferable to destructive treatment that can scar or alter pigmentation. Molluscum has central umbilication, Fordyce spots are ectopic sebaceous glands usually seen on the shaft, genital warts are less uniform, and lichen nitidus does not justify fungal screening.

Reference: PCDS pearly penile papules guidance: https://www.pcds.org.uk/clinical-guidance/pearly-penile-papules