II. Epidemiology
- Prevalence: <1% (U.S.)
- More common in white patients
- Age of onset >40 years
III. Symptoms
- Typically asymptomatic
- May rarely bleed or be pruritic
IV. Signs
- Red-blue, benign vascular Papules
- Typically 1-2 mm in size (up to 6 mm)
- Distribution
- Clustered on the glans penis, often linear along the margin
- May occur on Scrotum, groin, thighs, and abdominal wall
- Red Flag: Lesions on the penile shaft, suprapubic region or Sacrum
- Suggests Fabry Disease and requires referral (see below)
V. Differential Diagnosis
- Pearly Penile Papules
- Penile Cancer
- Fabry Disease (Lysosomal Storage Disease)
- May present with Angiokeratomas on the penile shaft, suprapubic region or Sacrum
- Fabry Disease is associated with Renal Failure, Cardiomyopathy, Hypertension, Anhidrosis and neuropathic pain
- Requires urgent Consultation
VI. Management: Symptomatic Cases (e.g. Bleeding)
- Electrocautery
- Cryotherapy
- Laser ablation
- Surgical excision