Do not confuse Fordyce's spots with penile warts

I wish to comment on the picture depicting penile warts (GP, 23 May). I am sure the author meant the lesion on the glans to indicate warts and not the pearly papules around the coronal region.

As a large student practice, we see many patients worried about normal parts of their penile anatomy. Some have been told that bits of normal anatomy are disease, most commonly mistaking pearly papules and Fordyce's spots for warts and some have even had unnecessary treatments.

With the personal hang-ups that many young men have it can be hard to convince them that they are fine.

Part of the problem is that we teach school children and training doctors from line drawings and diagrams, and even medical texts rarely have real pictures with natural variations.

Can we ensure that we are reassuring patients about these normal parts of their anatomy?

Dr Adam J M Connor, University of Nottingham Health Service.

GP replies: In the image used, the line of multiple lesions is indeed normal but the lesion higher upon its own was new and considered clinically to be a penile wart. It was treated and subsequently resolved.

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