War On Warts

Pearly penile papules are small raised nodules (bumps), usually 1-2 mm in size, which are located around the rim of the penis head in the form of string of pearls.  Usually developing during adolescence, they have been reported in up to 35% of males. Uncircumcised men are more likely to have pearly penile papules.  Very often these lesions are confused with genital warts, although there is no known link between warts and pearly penile papules.

Pearly penile papules are NOT cancer and are NOT spread via contact or sex. Most men with penile papules do not seek medical treatment.

Men do not need to have them removed but some men feel uncomfortable having spots or dots on the penis.  Some men are worried that a partner my not have sex with them because they look like warts or other sexually transmitted bumps such as herpes.

Many treatment methods have been tried, including circumcision and freezing. But these methods had proven to be either ineffective or have side effects.

Until recently,burning and carbon dioxide laser were considered the most effective treatment options.

Radiofrequency surgery was introduced into dermatology, it became a great option to remove unwanted papules effectively, safely, and with no scarring or bleeding.  Originally used to remove papules on the nose or other small bumps radiofrequency removal is an effect technique.   Because radiofrequency uses radio waves and not electricity, there is less damage to surrounding tissue and its small and light hand-piece allows for more precise and complete removal.

Usually one treatment is enough to remove all penile papules.

Treatment area is numbed with lidocaine cream making the area not sense pain or heat.   The skin takes a week to ten days to heal.  Patients can resume daily work activities that same day but we encourage no sexual relations until the healing process is finished

Tags: ellman penis, pearly penile papules, penile radiofrequency surgery, penile angiofibroma, penile cosmetic surgery, penile papule removal, radiosurgery, removal, war on warts, warts

Genital infection with low-risk types of HPV is associated with genital warts in men. Infection with high-risk types of HPV is associated with a proportion of preinvasive squamous lesions of the penis (penile intraepithelial neoplasia or PIN) and with penile cancer, as well as with preinvasive squamous lesions of the anus (anal intraepithelial neoplasia or AIN) and with anal cancer.

Invasive penile cancer is quite uncommon, especially in circumcised men.

In 2002, the age-adjusted incidence rate for penile cancer in the U.S. was 0.8 per 100,000 men (985 new cases). The age-adjusted incidence rate for anal cancer was 1.2 per 100,000 men (1,453 new cases). However, the risk of anal cancer for MSM is significantly higher.

Because of the increased incidence of anal cancer in MSM, especially HIV-infected MSM, some specialists recommend screening for AIN by cytology in this population. However, there are limited data on the natural history of AIN, the reliability of screening methods, the safety and response to treatments, and the programmatic considerations that would support this screening approach.

Until more data are generated on screening for AIN, this screening approach is not recommended.

There is currently no FDA-approved HPV DNA test for males, nor is HPV testing of males recommended. There is no clinical utility in testing men for HPV; infection does not indicate increased risk of disease for the man or his partner. While HPV is common in men, HPV-associated cancers are rare.

There are no routine methods for culturing HPV. Serology tests are available for HPV, but these tests are used only in research settings. Many persons with detectable HPV DNA do not have antibodies, so these tests are not a good method to indicate infection with HPV.

While it is possible that vaccination of males with the HPV vaccine may offer direct health benefits to males and indirect health benefits to females, there are currently no efficacy data available to support use of HPV vaccine in males. Efficacy studies in males are ongoing.

Additional information is available on the CDC website at:

http://www.cdc.gov/STD/hpv/hpv-clinicians-brochure.htm

To access treatment guidelines for HPV and genital warts, please review CDC s 2006 STD Treatment Guidelines available online at:

- HPV Infection

http://www.cdc.gov/std/treatment/2006/hpv.htm

- Genital Warts

http://www.cdc.gov/std/treatment/2006/genital-warts.htm

Tags: cdc, hpv