[Question #13670] HPV Warts Question

1 months ago

Hello, I am a 25 year old male from the Midwest. Around August/September of 2023, I noticed a bump on my penis. I was getting an STD general panel at a PP, asked, and they said it was likely a skin-tag. I also asked my PCP about it, who said the same thing. Flash forward to two weeks ago, and it’s still present, so I asked a PA at a dermatology appoint for something unrelated to double check. The PA said it was likely GW. They took it off and did a biopsy. The test came back positive for ‘condyloma acuminatum.’ I have never knowingly had sex with someone who has GW, and I was vaccinated with three shots (can’t find the specific shot) against HPV when I was 13 (years before I had sexual contact). Is it possible the biopsy was wrong? My understanding is most resolve within 2 years. I haven’t noticed any other bumps. Additionally, should I disclose this forever? I see so many conflicting things about whether the virus is actually “gone” or “cleared.” Thank you.

Edward W. Hook M.D.

1 months ago

Welcome to the Forum. Thanks for your questions. I'll be glad to provide some information. Here are some facts and comments:

Congratulations on getting the vaccine. It is the single best thing you can do to prevent HPV and it's spread. The vaccine however does not cover all of the more than 100 HPV types. The vaccine prevents HPV due to HPV types 6 and 11 which cause about 95% of all visible warts as well as the HPV types which cause the majority of abnormal PAP smears in women. Despite that, some folks get HPV due to other types which are sometimes manifest as warts. This may be what happened to you. (FYI, over 80% of persons who have not gotten the vaccine will have one or more (frequently more) HPV infections)

It is unlikely that the biopsy was incorrect if read by an experienced pathologist.

Your infection ifs not a big deal for the reasons I mentions above (everyone has them). You are correct that if untreated most warts will resolve without therapy in 2-3 years. Treatment hastens the resolution.

Unlike other STIs, we do not feel that disclosure is crucial- they are innocuous widespread infections which as mentioned above typically resolve on their own without jeopardizing the health of infected persons. There are literally hundreds of past discussions on the Forum discussing the issue of disclosure and when to do it - i recommend that you take a look at other thread on the Forum to see our thoughts. (there are also discussions on the issue of HPV clearance).

For women the single most important thing is to follow recommendations for regular sexual health check ups. For men, simply watching and seeking evaluation of any lesions which might be present is the recommended course of action.

I hope this information is helpful and useful. Take a look at other threads on the Forum- the titles tend to clear you on the topic being discussed. If anything is unclear, please don't hesitate to use your up to 2 follow-ups for clarification. EWH

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1 months ago

Specimen information: MICROSCOPIC DESCRIPTION: Sections show a gently lobulated protuberant skin lesion with acanthosis and vacuolization of upper spinous and granular layer cells with hyperchromatic, round nuclei. Clinical information: A)Morphology: flesh colored papule DDX: skin tag r/o condyloma Final pathological diagnosis: CONDYLOMA ACUMINATUM. Please let me know if you believe this is accurate based on description, thank you.

Edward W. Hook M.D.

1 months ago

The description match’s descriptions of the microscopic characteristics of genital warts. The tern condylomata accuminatum is a synonym for genital warts.

One follow up remaining. No change in my assessment or advice. EWH

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1 months ago

Thanks, Dr Hook. So I’ve since been to my PCP several days ago, and noticed one other wart. We did cyro to remove it. It hasn’t fallen off yet, but I haven’t noticed any others. To clarify, I’ve looked around this site and others, and most seem to believe once the warts have not reoccurred for 3-6 months, safe to assume it’s suppressed and will not be spread, correct? Last question- I’ve heard mixed things about spreading warts to myself, particularly from shaving. How likely is this? Should I avoid shaving while I have a wart?

Edward W. Hook M.D.

1 months ago

Final Response.

Many of our clients worry about spreading of there warts by touching or scratching them but the fact is that this is a very, very rare occurrence. Shaving, by disrupting the shaved skin promotes makes the spread of warts more likely although precisely how common this is is not clear. I would avoid shaving warts as this could potentially spread them. Once they are treated and the site where they were has healed, shaving the area is OK. EWH

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