Pearly Penile Papules: A Systematic Review of Treatment Modalities

Because pearly penile papules (PPP) are common, asymptomatic, and benign lesions that are often cosmetically bothersome to patients, we sought to systematically review all available treatment options for PPP.

PubMed, Scopus, Embase, and Cochrane databases were queried with relevant terms, with all articles describing treatment modalities for PPP included in this review. Articles related to PPP but lacking treatment information or without novel clinical or patient data, unrelated to PPP, or not available in English were excluded.

The database query yielded 254 unique articles. After screening and evaluation for duplicates and inclusion and exclusion criteria, 17 publications, all of which were retrospective case reports or case series, with 142 patients were included and analyzed. The most common modality used was ablative laser (10 articles), eight of which involved carbon dioxide laser, as well as erbium yttrium-aluminum-garnet (YAG) and holmium:YAG lasers. Liquid nitrogen (3 articles) and single reports of pulsed dye laser, nonablative 1550nm fractional laser resurfacing, and electrocoagulation with or without 30% trichloroacetic acid peel were also found. Most articles reported complete lesion removal and high patient satisfaction with no reports of infection or scarring.

This review is primarily limited by publication bias, with variable or limited methods of reporting efficacy/response and adverse event data.

Multiple modalities can achieve safe and effective treatment of PPP with high patient and provider satisfaction.