What disease is it that causes two granulations to grow in the coronal sulcus?

In fact, the male penis is the same as the female vagina. It is also a reproductive organ and needs to be properly maintained in daily life. If it lacks relevant maintenance, it is strange that it does not get sick. For example, the male penis is usually covered by the foreskin. Only when the foreskin is turned back can the glans be seen. At this time, a careful observation revealed that two granulations grew in the coronal sulcus. What disease caused this?

Hirsuties papillaris genitalis, also known as penile pearly papules, coronal sulcus or glans papules, is also called hairy penis or multi-papillary penis by some scholars. Currently, most scholars believe that this is a normal physiological variation, so it will not affect health and will not be infected or spread through sexual intercourse.

Causes

The cause and incidence of penile pearly papules are still unclear. Some scholars believe that this disease is a kind of abnormal physiological development. Some scholars believe that it is related to prepuce. Surveys have found that the incidence of penile pearly papules in young men with prepuce is significantly higher than that in men with normal prepuce. Some scholars believe that this disease may be related to HPV infection, but Ferenczy et al. and Zhang Kaijin et al. tested HPV in the lesion tissue and found no HPV. The author observed that the direct cause of this disease may be inflammatory reactions such as local redness and swelling caused by prepuce, poor local hygiene, long-term stimulation of coronal sulcus secretions and dirt, or other factors such as infection. If the patient needs treatment, it can be treated through laser surgery, cryotherapy, and drug therapy.

Clinical manifestations and diagnosis

Pearly penile papules are more common in men around 20-30 years old. The damage mainly occurs at the junction of the edge of the glans penis and the coronal sulcus and/or the frenulum. The lesions are 1-3mm in size, and the lesions are larger on both sides of the frenulum. The top of the papules is round and smooth, and some papules are hairy or thread-like. The papules are mostly not fused with each other, and are densely arranged in one or more rows. They are obvious on the dorsal side of the glans penis and may partially or completely surround the glans penis. The color of the lesions is mostly pearly white, a few are light red or skin-colored, and some may appear mildly red and swollen. There is no tenderness, no rupture, and the patient has no subjective symptoms.

The key point in differentiating and diagnosing penile pearly papules and condylar warts is that in the former, the lesions are limited to the edge of the glans, the number of lesions is larger, they are pearly milky white papules with a smooth surface, the lesions do not increase in size as the course of the disease prolongs, and the acetic acid test is negative; while in the latter, the lesions are not limited to the edge of the glans, they are mostly single and scattered, the lesions are larger, the surface is not smooth, and they are mostly cauliflower-shaped, they gradually increase in size as the course of the disease prolongs, the acetic acid test is positive, and concave cells are found in histopathological examination.

Treatment options

Pearly papules of the penis (abbreviated as pearly papules) are a benign disease. Some people may disappear after a certain period of time, while others may remain unchanged for decades. Since pearly papules are not contagious and do not harm health, they do not need to be treated. However, in order to prevent the disease from getting worse, prevention and care are important. If it is caused by prepuce that is too long, treat the prepuce as soon as possible.

If patients with pearly rash require treatment, the following treatment methods can be used:

(1) Laser therapy

Advantages: Laser therapy is a high-temperature treatment, and the temperature can reach over 700°C. It mainly carbonizes and scabs the pearly rash tissue. After the scab falls off, the wound is covered with new squamous epithelium. The treatment of pearly rash generally uses a carbon dioxide laser with a wavelength of 10.6μm infrared light. The preparation before treatment is the same as that of electric ironing. In addition to the thermal effect, its advantages also include pressure, photochemical and electromagnetic field effects. Therefore, it has anti-inflammatory (stimulating the body to produce a stronger defense immune function), analgesic (reducing tissue edema, reducing chemical and mechanical stimulation to nerve endings) and promoting tissue repair (enhancing the synthesis and metabolism of epithelial cells, promoting epithelial hyperplasia, and accelerating wound repair), so the treatment time is short and the cure rate is high.

Disadvantages: The cost is high, and the imported laser equipment is expensive, so the price of removing pearly rash is also high and it is easy to relapse. After the operation, you need to change the dressing regularly to avoid infection until you are fully recovered.

(2) Cryotherapy

Advantages: Cryotherapy is a kind of ultra-low temperature treatment. The cooling source is liquid nitrogen, and the temperature is -196℃. During treatment, choose the appropriate probe according to the condition of pearly rash. To improve the efficacy, the freeze-thaw-freeze method can be used, that is, freeze for 1 minute, warm for 3 minutes, and freeze again for 1 minute. Its advantage is that it is simple to operate.

Disadvantages: Liquid nitrogen sprays out gas, and the area is difficult to control. It is easy to cause blisters, infection, and scarring after freezing. It is not as well-known as laser therapy.

(3) Drug treatment

Advantages: It acts on the necrosis and shedding of pearly rash, the process is easy, and because it is for external use, there are no side effects and it is not easy to recur.

Disadvantages: The treatment time is relatively long, needing 5-10 days, and the place where the medicine is applied cannot be exposed to water for 24 hours, otherwise it will affect the effect.