Pearly penile papules (PPPs) are normal small bumps that can occur on the penis. ^{[2] [3]} They vary in size from 1 - 4 mm, are white or flesh-colored, smooth and dome-topped, and appear in one or several rows around the ridge of the head of the penis and sometimes on the shaft. ^{[2] [4]} In a Black person, they generally appear whitish. ^[5] They are painless, non-cancerous, and harmless. ^[2]

They are a type of angiofibroma, whose function is not well-understood. ^{[3] [1]} They are sometimes described as remnants of penile spines, a sensitive feature found in the same location in other primates. ^[6] PPPs secrete oil that moistens the head of the penis. ^[7] Diagnosis is by visualization. ^[3] On dermoscopy, they appear in a cobblestone-like pattern, with a central dotted or comma-shaped blood vessels, and without scaling. ^[1] Examination of a tissue biopsy shows dense connective tissue, fibroblasts, and many blood vessels. ^[4] They are sometimes mistaken for genital warts, molluscum contagiosum, sebaceous hyperplasia, or lichen nitidus. ^{[8] [2]}

Generally, reassurance is given and no treatment is needed. ^[3] Following counselling, cryotherapy, laser therapy, or shave excision may be options for cosmetic reasons. ^{[9] [3]} Some home remedies involving corrosive substances can be damaging. ^[10] They do not spread and often spontaneously regress. ^[11]

PPPs are common, occurring in up to half of young males. ^{[1] [2]} They are more common in uncircumcised people. ^[2] They were first described in 1700 and the term "pearly penile papules" was coined in 1964. ^[1] Some find them distressing to look at, owing to their resemblance to some sexually transmitted infections. ^{[1] [12]}

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