There are white bumps on the baby's glans

Some parents found white bumps on their baby's glans when changing diapers. This is medically called glans papules. The incidence rate in children is very small, and it usually occurs in young people around 20 years old. In most cases, this is caused by hygiene problems. This article introduces the causes, clinical manifestations and diagnosis, treatment plans and several treatment methods of glans papules. Let’s take a look at the details.

Pearly rash (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.

Causes

The cause and incidence of pearly penile papules are still unclear. Some scholars believe that this disease is an abnormality of physiological development. Some scholars also believe that it is related to the foreskin being too long. The survey found that the incidence of penile pearly papules in young men with foreskin being too long is significantly higher than that in those with normal foreskin. Some scholars also believe that the disease may be related to HPV infection, but Ferenczy et al. and Zhang Kaijin et al. detected HPV in the lesion tissue and found no HPV. The author observed that the patient's foreskin was too long, the local hygiene was poor, the long-term stimulation of the coronal sulcus secretions and dirt, or other factors such as infection caused local redness and swelling and other inflammatory reactions may be the direct cause of this disease. 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 lesions mainly occur at the junction of the edge of the glans and the coronal sulcus and/or the frenulum. The lesions are papules of 1-3 mm in size, and are larger on both sides of the frenulum. The top of the papule is round and smooth, and some papules are hairy or thread-like. The papules are usually not fused together and are densely arranged in one or more rows. They are obvious on the dorsal side of the glans and may partially or completely surround the glans. The lesions are mostly pearly white in color, a few are light red or skin color, and some may appear slightly red and swollen. There was no tenderness, no ulceration, and the patient had no subjective symptoms.

The key point in the differential diagnosis between pearly penile papules and condyloma acuminatum is that in the former, the lesions are limited to the edge of the glans, the number of lesions is large, they are pearly milky white papules, the surface is smooth, the lesions do not increase with the progression of the disease, 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 large, the surface is not smooth, and they are mostly cauliflower-shaped, they gradually increase with the progression of the disease, the acetic acid test is positive, and histopathological examination shows concave cells.

Treatment options

Pearly penile papules (abbreviated as pearly rash) is a benign disease. In some people, it may disappear after a certain period of time, while in others, it may persist for decades without change. Since pearly rash is not contagious and does not affect health, it does not require treatment. However, in order to prevent the disease from getting worse, the emphasis is on prevention and care. If it is caused by foreskin that is too long, treat it as soon as possible.

If patients with pearly rash require treatment, the following treatment methods are available:

(1) Laser therapy

Advantages: Laser therapy is a high-temperature treatment with temperatures reaching over 700°C. The main function is to carbonize and form scabs on the pearly rash tissue. After the scabs fall off, the wound surface is covered with new squamous epithelium. The treatment of pearly rash generally uses a carbon dioxide laser and infrared light with a wavelength of 10.6μm. Preparation before treatment is the same as that for electric ironing. In addition to thermal effects, its advantages also include pressure, photochemical and electromagnetic field effects. Therefore, it has anti-inflammatory effects (stimulating the body to produce stronger defensive immune functions), analgesic effects (reducing tissue edema and reducing chemical and mechanical stimulation to nerve endings) and promoting tissue repair (enhancing the anabolism of epithelial cells, promoting epithelial proliferation, and accelerating wound repair). Therefore, the treatment time is short and the cure rate is high.

Disadvantages: High cost, imported laser equipment is expensive, so the cost of removing pearly rash is also high and it is prone to recurrence. After surgery, dressings need to be changed regularly to avoid infection until full recovery.

(2) Cryotherapy

Advantages: Cryotherapy is an 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 therapeutic effect, the freeze-thaw-freeze method can be used, that is, freezing for 1 minute, thawing for 3 minutes, and freezing again for 1 minute. Its advantage is simple operation.

Disadvantages: The disadvantage is that liquid nitrogen sprays out gas, the area is difficult to control, and it is easy to cause blisters after freezing, which is prone to infection and scarring. Less well-known than 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, it has no side effects and is not prone to recurrence.

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.