[Question #10166] HPV

25 months ago

Man I’m sad to be back..

For the past 2 months or so I’ve had these shiny flesh colored bumps on my shaft. They are completely asymptomatic. My PCP has examined them (twice)and said it doesn’t resemble an STD and most likely neurodermatitis. They do not itch at all and are not getting better.

In a panic I called Everly well. An online physician group in which I spoke to an NP. I explained my symptoms over the phone. He did not view the lesions but based on my description diagnosed HPV and sent in an RX for Aldara.

I’m at a lost..if it is genital warts what are my next steps…wouldn’t my pcp of 25 years (I’m 43) been able to recognize HPV? Any advice or help is greatly appreciated!

H. Hunter Handsfield, MD

25 months ago

Welcome back, but I'm afraid we can't help. We do not examine patients (or their photos) -- we cannily address risks and probabilities. From your description and your PCP's diagnosis, I doubt you have genital warts. You've gotten yourself into trouble by seeking a second opinion, based purely on your description and no examination of your penile bumps, when you already had a good diagnosis from an in-person examination -- and by an experienced physician, more highly trained (and likely more experienced) than a nurse practitioner. I would never recommend anybody treat themselves for warts based on the second opinion you describe. But the best way to resolve this dilemma is to recheck with your PCP and ask him or her about her confidence in the diagnosis.

Sorry, but that's all I can do. However, I would also observe that you're obviously abnormally anxious about minimal to zero STD/HIV risks and problems. There's not much we can do about such underlying personality issues. If thoughts like the ones in your several forum threads are dominating your life much of the time, professional counseling may be in order. I raise this possibility from compassion, not criticism. But a good starting point would be a discussion with your PCP when you re-contact her about your penile bumps.

Best wishes-- HHH, MD

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25 months ago

Thank you for your quick response..I just know there is something abnormal on the shaft of my penis. I’ve only been sexually active with one girl in the past 4 months who said her pap was normal.

I understand there’s most like 100s of causes of penile bumps. Should I d/c the Aldara until I speak to my pcp or a dermatologist? I appreciate your work..

H. Hunter Handsfield, MD

25 months ago

I have no view on whether the "something" on your penis is abnormal. That doesn't mean they are warts. That your sex partner has had a normal pap is irrelevant: Pap smears do not diagnose warts.

I already said I would never treat presumed warts with imiquimod (Aldara) or anything else without a more secure diagnosis. Not only might it not work, but it likely would alter the appearance and could make make accurate diagnosis more difficult. I already suggested to return to your PCP or at least speak with him or her, but seeing a dermatologist is another alternative. You could do both: discuss with your PCP and see if s/he advised referral to a dermatologist. For sure no treatment until the diagnosis is known.

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25 months ago

Ok. Thank you for your expertise. Just out of curiosity going forward. If it is Hpv warts…obviously I will get them treated. What about disclosure to future partners..and do I need to worry about transmission to my 5 year old?

Thanks again

H. Hunter Handsfield, MD

25 months ago

It won't turn out to be warts, but if it is, disclosure to future partners is not necessary once they are treated and do not recur within a couple of months. HPV and genital warts are not transmitted non sexually; there is no risk to children or other household members regardless of shared toilets, towels, etc.

That concludes this thread. I hope the discussion has been helpful.

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