Search

An 11 year old boy was referred to us by his general practitioner for evaluation of small papules on the shaft of his penis. The history revealed that they appeared one year before, were asymptomatic and had not spread. Before his referral the lesions had been interpreted as molluscum contagiosum and were removed by curettage several times, but they always relapsed. On examination we observed three flesh coloured glistening, papules, 2 to 3 mm in diameter with elevated borders and annular shape (fig 1). The patient was otherwise healthy and showed normal development. A biopsy specimen of a papular lesion revealed vascular dilatation and fibrosis in the dermis (fig 2). A diagnosis of pearly penile papules (PPP), were therefore made. The term PPP describes a distinct entity affecting young adults, characterised by multiple, flesh coloured or pearly white, domeshaped, 1 to 2 mm diameter papules generally localised on the corona and sulcus of the glans pemis. 2The lesions arranged in groups or in rows are fixed and do not spontaneously regress. Pathological examination always reveals enlarged vascular spaces associated with fibrosis in the dermis.3 The aetiology of PPP is unknown. Recently, a male adult with ectopic angiofibromas on the shaft associated with typical lesions on the corona has been described by O'Neil and Hansen.3 These authors considered the condition a distinct clinical subtype of PPP. When a few papules are localised exclusively on the shaft, as in our case, the diagnosis is not obvious and the differential diagnosis includes condylomata acuminata, molluscum contagiosum, heterotopic sebaceous glands and lichen nitidus that * ,,j,.w..bo v i. w , %. h..:S' t. '> % .') .4 w n,>' j~~~~~~.

Vulvitis chronica plasmacellularis or Zoon's vulvitis is a rare benign circumscribed inflammation of the vulvar mucosa. It is found in women ranging in age from 26 to 70 years. Shiny, macular erythematous lesions, which are irregular in shape and sharply marginated are usually observed. The histologic findings show chronic subepithelial dense inflammation composed largely of plasma cells. We here report two cases of vulvitis plasmacellularis with typical clinical manifestations, courses and histopathologic findings.