Hello. I’d like your take on my test results. About 4 years ago I developed a raised, brown spot on my perineum. At the time I was 35, had been with my husband for 3 years, and was pregnant. A year later, I developed a similar spot between my anus and thigh. My GP and OB/GYN both saw them and didn’t mention anything/weren’t concerned. I saw a derm PA who said they looked normal and to check again in one year. I saw the same PA a couple months ago and she said offhandedly that they could be warts, but she didn’t think they were. She said I could get it biopsied or continue to monitor it yearly. I went to a derm who said they were condyloma vs SKs vs benign nevi. The results came back as ‘a gently lobulated protuberant skin lesion with acanthosis and vacuolization of upper spinous and granular layer cells with hyperchromatic, round nevi.’ The pathologist put the diagnosis as condyloma, but from what I’ve read that doesn’t match this description as there were no ‘halos’, ‘irregular nuclei’, etc. I question the diagnosis because 1) my age and the fact that I hadn’t had any new partners for years 2) I’ve never been diagnosed with an STI, have had all negative HPV tests and Paps, and had the HPV vaccine series ten years prior. 3) I was pregnant at the time and carrying and extra 50 lbs. I read that hormones and friction can cause SKs. 4) My father is covered in SKs and I know they are genetic. I just had one removed from my back. Please share your interpretation of my results. Should I have them sent to another lab for a second opinion?

Welcome to the Forum.  Thanks for your questions.  I'll have some comments but am not a pathologist and they speak a language of their own.---

Thank you for your response. They removed both spots via shave excision at the time of the biopsy, so at least they are gone. The dermatologist agreed to send the sample to a second lab if I want a second opinion, which I think I will do. She also thought HPV DNA testing might be helpful for diagnosis and determining if it is low or high-risk HPV. That didn’t make sense to me as I told her I tested negative for the high-risk strains of HPV at my annual exam just last week. Would you recommend the DNA testing? Worse case scenario, if the diagnosis was correct and I haven’t had any new ‘warts’ in three years, does that mean I’ve cleared the virus?

Checking with the 2nd lab sounds reasonable, given your questions.  DNA testing could provide additional information.---

Thank you again for your response! Your answers are reassuring. Regarding the timing, the first lesion appeared maybe four years ago, then another similar one appeared about a year later in a different spot. Nothing since then. I didn’t have either of them removed until last week as no one seemed concerned about them. I would agree that there is not much else to do regardless of what a second lab concludes. That is why I’m struggling with getting a second opinion or just trying to forget about it and move on with my life!

I understand your dilemma.  I don't have too much to add but will leave the thread open for another 30 days in case you wish to share the results of the 2nd pathologist's interpretation.  EWH---