[Question #12789] HPV-No prior outbreak

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5 months ago
Married for 10 yrs. Spouse had 15 yr old mole biopsied. Neg hpv. Derm swears its hpv still. I was pregnant a year-ish ago, 2 bumps on my groin/thigh appeared. MD not worried. Recently, small, brown, and flat papules on mons pubis-like groin appeared. Biopsy: shows features of warts. type pending. I am vaccinated- unsure if before 1st sexual encounter. No prior outbreaks. How likely is this an old infection vs new? why + 10yrs later? If old, can I still clear this? I think the outbreak is due to extreme stress lately.  Lastly, what is the likelihood of having exposed my kids since we take baths together occasionally/use the same wash cloth sometimes? Do I need a pap smear? Prior paps negative. Can this be regular warts that aren't sexually transmitted?
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H. Hunter Handsfield, MD
5 months ago
Welcome to the forum. Thank you for your confidence in our services.

I don't fully understand the situation. Moles are not caused by HPV; and if a biopsied mole didn't test positive for HPV, I can't figure out why your dermatologist still thought HPV was the cause. Was it really a mole or some other sort of skin condition, i.e. a wart?

Warts in the groin or pubic area, but not the genitals (labia, vaginal opening, etc) are not necessarily caused by the sexually transmitted strains of HPV. And "features of warts" under the microscope isn't necessarily accurate. However, if these lesions turn out to be warts, it's more likely reactivation of a distant past infection than a new one. Just because it might be a reactivated infection doesn't men it will continue; in other words yes, your immune system will clear it over time.

Don't guilt yourself about stress. There is absolutely no evidence that stress, anxiety, or other psychological issues increase the chance of reactivation of HPV or otherwise contribute to appearance of warts.

Finally, there should be zero worry about your kids. HPV is never transmitted to non sex partner household members of persons with genital warts even after years of sharing toilets, towels, baths, kitchens, utensil, etc.

Should you continue to follow standard recommendations for regular Pap smear? Yes, of course. Not because of this particular problem, but because all women need regular HPV testing.

Could this be non sexually transmitted warts? Probably yes. First discuss with your dermatologist whether they are warts of any kind. If so, the origin and virus type doesn't matter. Although nobody wants warts, whether genital or non genital, almost always they are an unpleasant inconvenience, not an important health risk. This really doesn't sound like a worrisome situation. The chance of any serious health problem is zero or close to it. I'm sure your dermatologist would agree!

I hope this reply is helpful. Let me know if anything isn't clear.

HHH, MD
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4 months ago
Thank you for answering my questions. Regarding my husband, all of his doctors thought they were moles. His derm is adamant, even after the biopsy and typing, that it was still a wart. She said the virus probably wasn't active in it since it had been a decade, so the virus wouldn't be found in the biopsy. My typing came back neg for high and low risk hpv. Does this mean its not HPV? Should I be concerned? I'm not sure what else this could be. Due to the location, my baby's foot rubs on it as he stands on me when I wear shorts. Is this still low risk? My derm isn't concerned and rec cream and freezing.
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H. Hunter Handsfield, MD
4 months ago
Thanks for the follow-up information. The opinion of your husband's dermatologist doesn't fit with common scientific understanding about warts. Your husband might consider getting a second opinion e.g. another dermatologist or maybe a urologistn. Whatever he has almost certainly is harmless. Same for you, and you can count on the reliability of your negative HPV tests. As for "what else this could be", there are other kinds of skin bumps and growths than warts. And even if you had HPV, it cannot be transmitted to your child or anyone else by the sort of contact you describe; I'm sure your dermatologist is right to be unconcerned.---
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4 months ago
Since I am not allowed to respond again after the second question. I wanted to thank you for your help and patience.  To confirm, is it likely that what I have isn't a wart? Or it can still be a wart, just not a common one.  I'm confused that it looks wart-like under the microscope, but typing was negative. My derm is still considering it a wart. I'm wondering if I should continue with this treatment if it's not likely a wart. At most, I could freeze it and see rather than cream and treatment.  Thank you for the reassurance, I'm relieved to know it's nothing bad.
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H. Hunter Handsfield, MD
4 months ago
Since microscopically it's a wart, that's what you have. Whether it is called a genital or common wart doesn't matter:  it's the identical problem. Whether or not you acquired the underlying HPV infection sexually or not doesn't matter either. Who cares? That it tested negative for HPV doesn't change anything:  there are over 100 HPV types, of which only 10-15 are detected with the standard tests. As for the best treatment, your dermatologist is in a far better position than I am to judge the best treatment. But if you want rid of it right away, why not ask him (or her) about laser cautery of some other form of immediately removal? 

That completes this thread. I hope the discussion has been helpful and that you will look at this issue, i.e. both your wart and your husband's problem (whatever it is) as the very minor health problems they are, truly nothing to be seriously concerned about. They are minor inconveniences, not important health problems!

Best wishes and stay safe!
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