Craniofacial features of isotretinoin embryopathy

Abstract

The differential diagnosis includes verrucae accuminata (venereal warts) and ectopic sebaceous glands. Venereal warts tend to be of less uniform size and shape, usually change over time, and are not neatly arranged around the corona of the penis. Ectopic sebaceous glands are common penile lesions characterized by barely elevated discrete yellow papules on the penile shaft? The lesions increase in appearance on stretching the penile skin and a cheesy material may be expressible. Pink pearly papules seem to originate at the t ime of maximum physiologic pubertal changes, when males may have questions about changes in genital size and coloration. Adolescence is also a time of sexual experimentation and incomplete knowledge in the areas of sexuality and sexually transmitted diseases. In our experience, adolescents with prominent PPP seek medical attention, not with a sense of cosmetic abnormality but with concern that they have developed VD or have acquired a tumor as a result of masturbation. With simple reassurance all of our patients have been relieved and completely satisfied with the explanation. None has ever asked about cosmetic surgical revision. We have been surprised by most clinician's lack of familiarity with this normal developmental variant. Many physicians may confuse PPP with some form of genital wart or tumor and treat unnecessarily, with potentially painfiil results. Pink pearly papules require no treatment other than reassurance to the patient.