ABSTRACT
Pearly penile papules (PPP) and vestibular papillae (VP) are common, benign lesions of the male and female genitalia. PPP are present in 14–48% of males and are more common in African American and uncircumcised men. VP show a prevalence rate between 1% and 33%. PPP and VP are quite often interpreted as genital warts, causing, on many occasions, incorrect or unnecessary treatments. A skin biopsy should be considered if the clinical presentation is doubtful. PPP and VP show similar features at dermoscopy, namely characteristic regular, uniformly sized, whitish-pink small projections, which have separate bases. Histopathologically, the whitish-pink small projections observed at dermoscopy correspond to connective tissue papillomatous structures including slight dilated and elongated vessels. The epidermis is normal or acanthotic, with no aspects of HPV infection.
