There are small granulations on the edge of the glans penis. Be careful of condyloma acuminatum.

Many men will find some small granulations on their glans when taking a shower. The skin surface of the glans of a normal person should be smooth. Even if it is a common allergy, some slight rashes and bumps will appear under the pubic hair. However, if small granulations appear, it means that it may be genital warts. Early genital warts are small barbs in light red or pink color, similar to cauliflower, without pain but with secretions. They often appear at the urethral opening, anus and glans.

Typical clinical manifestations of condyloma acuminatum in men

The basic lesions of male condyloma acuminatum are initially small, light red bumps of varying sizes, distributed singly or in clusters, moist and soft, with nipple-like, cockscomb-like or cauliflower-like protrusions, red or dirty gray, often with pedicles at the roots, and prone to erosion and exudation, and easy to bleed when touched. Puscular secretions often accumulate between the cracks of skin damage, causing a foul odor, and secondary infection is often caused by scratching. Due to continuous local moisture and chronic stimulation, they often grow rapidly. This disease often has no spontaneous symptoms, and some patients may experience local pain or itching. Occasionally, it can transform into squamous cell carcinoma.

Condyloma acuminatum that occurs at the urethral opening or anterior urethra is generally not easy to observe. Because male condyloma acuminatum is rich in blood vessels and easily bleeds, some patients often come to the doctor because of blood in the urine after sexual intercourse or after exertion, and generally there are no spontaneous symptoms such as pain. Condyloma acuminatum that occurs in the anus is easier to be confused with hemorrhoids, but condyloma acuminatum that occurs in the anus is difficult to observe without a proctoscope, and sometimes the instrument manifests as bleeding after defecation. The skin around the anus is wrinkled and there is a lot of friction when walking, so once condyloma acuminatum occurs, it often occurs frequently. At the beginning, there are mostly papules, and then the warts grow in a swollen shape, which can be large cauliflower-like with a pedicle, and more often flat plaques with small nipples on the surface. Due to secondary infection, the secretions often have an unpleasant odor. In some cases, lesions may appear in the mucosal epithelium of the anus. If they occur around the anus, the patient should be asked whether he has a history of homosexuality or anal sex.

Giant condyloma is a special form of condyloma, which can be the size of a fist and has a cauliflower-like surface. Due to secondary infection, the secretion often has an unpleasant odor. It is common in the foreskin mucosa and glans of male condyloma. Giant condyloma is actually a wart-like cancer. The pathology is a change of low-grade squamous cell carcinoma. Although it rarely metastasizes, the damage can penetrate deep. In men, it can invade the urethra and produce many sinuses, from which pus and urine are discharged.

Human papillomavirus (HPV) causes warts on the skin and proliferative lesions on the pharynx, perianal area, and male genital mucosa. The virus type is a small DNA virus. Most of the lesions caused by HPV infection are benign and can disappear on their own, but there are also cases of malignancy. For example, there are reports of squamous cell carcinomas forming on the perianal area and male genital mucosa. There are also rare hereditary skin diseases, such as epidermal dysplasia verrucosum (EV), which is secondary to skin cancer, and HPV has been detected in cancer cells.

HPV is a member of the genus A of the family Papovaviridae. The virus particle diameter is 50-55nm, and the virus shell is composed of a regular icosahedron without a membrane. It has a circular double-stranded DNA composition of 7900 base pairs. The size and shape of the virus particle under the electron microscope are very similar to those of oral polyomavirus. Papillomavirus (PV) is species-specific, and HPV has not yet been able to reproduce in tissue culture or experimental animal models.

Structural protein composition of male condyloma acuminatum virus : 85% of PV particles were identified by sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS-PAGE) to have a major capsid protein with a molecular weight of 56,000; a minor capsid protein with a molecular weight shift of 76,000; and 4 cellular histones were found to be associated with viral DNA.

The genome structure of all male HPV viruses is similar. The type and subtype of the virus can be determined by a DNA hybridization procedure under strict conditions. Only 50% of the DNA of different male HPV types cross-hybridizes with the DNA of other types of viruses. To date, more than 60 types of HPV have been discovered. As research deepens, more new types of HPV will be identified.