[Question #3279] Genital Warts or Molluscum Contagiosum?

36 months ago

Hello Dr. HHH/Hook, Last time i was here, i was asking about Anabolic Steriods & its effect on the 4TH Gen HIV test.

A Little Backround, Im a 24 Year old, Male, have been in a monogamous relationship with my girlfriend for the last 10 months (April, 2017). we have been sexualy active with each other and dont use protection.

Fast forward to October, i started noticing 2 bumps in my pelvic region. They looked flesh colored, pearly looking when you shined light on them, didnt hurt or itch. At first glance i thought they were either Genital Warts or Molluscum Contagiosum . I Visited my GP and he stated they are Skin Tags and froze them off. 3 weeks later, 3 new bumps appeared, same appearence as the other two, different location. So i just left them alone for about 2 months and they seemed to have gotten bigger. A couple of days ago, two other bumps showed up so i scheduled an appointment with a dermatologist . My Questions are....

1) I have read a lot about Molluscum Contagiosum and it says Adults rarely get them unless they are immunocompromised (HIV/AIDS). Is this True?

2)I spoke to Dr Hook and he assured me that anabolic steriods dont have any significant effect on my HIV Test results i took 81 days after my last encounter with a diffrent girl outside my relationship (March 26, 2017), did the HIV 4th Gen test give me a false negative (I was using Anabolic Steriods durring the test period)? The reason why im asking this question again is because of my recent outbreak of genital bumps. (Molluscum)

3)Is it possible that my girlfriend gave me these bumps even though she has no symptoms or bumps or was it the girl i was with before my relationship approximitlly 7 months before the first bumps appeared?

4)does this sound like Molluscum or HPV Warts?

i will report back once i visit my Dermatologist in 2 days, thanks and best regards.

 


H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
36 months ago
Welcome back to the forum.

You don't say where in the "pelvic region" these spots are. You're on the old side for newly acquired molliscum contagiosum, although not greatly so. But that's very unlikely if your sexual history is accurate, i.e. mutual monogamy for 10 months. The large majority of genital bumps or other skin problems are not STDs of any kind. (I have a book titled Genital Dermatology Atlas. Of its 300 pages of photos, only 15 pages cover STDs.)

1) Initial MC as an STD is most common in teens and young adults. Later onset is often recurrence of a previously dormant infection, becoming active because of immune deficiency. But this would never be the only evidence of immune deficiency. Such persons almost always are chronically ill with multiple other symptoms, e.g. in AIDS patients, advanced cancer, potent chemotherapy, etc.

2) I agree with all you have been told previously about this.

3) Not knowing the cause, I cannot speculate on the origins. If your diagnosis is eventually confirmed as either molluscum or warts, then it would be possible you acquired the infection from her. But not necessarily.

4) I cannot judge accurately based on this description. You'll need to rely on the more accurate assessment of the professionals who have examined you.

Let me know how things stand after you have seen the dermatologist. I won't have anything more to say until then. In the meantime, I hope this information is helpful.

HHH, MD
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36 months ago

Thanks for the information DR. H,


I Visited my Dermatologist today and he confirmed the diagnosis as Molluscum  Contagiosum.  He was a bit surprised also that my age group doesn't get them often. He also wanted me to take a HIV Test and that's what worries me. I told him I took one back in June and he said we should take one again. There was about six of them total and one on my thigh, he froze them off. My questions are.....

1) I took a HIV 4th Gen test on June 14, approximately 81 days after the one encounter that worries me, is it possible that test could have missed infection?

2)I was on Anabolic Steroids from March to July, could that have compromised my Immune system for me to be susceptible to Molluscum?

3) My girlfriend and I both tested full STD Panel on June 14th and everything was negative for both of us, my last encounter was March 26, 2017 (81 Days after) (one night stand) I'm just worried something was missed? is that possible after 81 days something was missed? I was on ANABOLIC STERIODS at that time.

4) If you were my Doctor, would you be worried of HIV because of my Molluscum diagnosis at my age (24)

5) I just took a HIV antigen and Antibody test today, how confident are you that my results will stay negative knowing iv been monogamous for the last 10 months. The last Girl I was with (other then my GF who I know is negative) was March 26, 2018 and I took the HIV 4th Gen test 81 days after(it was negative).


Thanks for all your help and hopefully everything comes back negative, I'm not really worried about Molluscum, just that the reason Adults get it is because of Compromised Immune Systems(HIV), that's my main worry.


H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
36 months ago
Thanks for the information. Glad to hear you have a diagnosis so you can stop worrying about more serious conditions.

It is not true that "the reason adults get it [MC] is because of compromised immune systems (HIV)". As I said above, most cases of genital area MC are sexually acquired, and are no more common in people with and without HIV. And although MC sometimes recurs in previously infected people who become immune deficient, those lesions are usually on the face, arms, and upper body (recurrences of childhood infection in these locations); and only are seen in peoplle with advanced HIV, i.e. overt AIDS, usually 5+ years after becoming infected; and as also said previously, would never be the only or main symptom of HIV or other immune deficiency. Your sexual history is most consistent with you catching MC from your regular partner. She should be checked -- or at least examine herself for suspicious lesions and seek care if she finds any. 

1,4,5) For the reasons already discussed, you definitely can expect a negative HIV test result. Your dermatologist is being careful and conservative, and it sounds like he's a caring, competent physician. Your MC doesn't raise my concerns about HIV.

2) Corticosteroids in high doses case immune suppression. Anabolic steroids do not.

3) Anabolic steroids also are not known to increase susceptibility to STDs or any other infection, or to alter the reliability of any lab tests.

Don't let the MC diagnosis throw you.  You're obviously obsessed (guilty?) about your use of anabolic steroids and some sexual choices you have made. Deal with those emotional/psychological issues as you need to (counseling?), but try to separate those concerns from infection risk. They aren't the same.

Feel free to post your HIV test result when you have it, but I won't have any other comments or advice until then. If any other questions come up, re-read all my replies in this and your several previous threads. Almost certainly the answers are there, and they will not change by asking the same thing a second, third, or fourth time.

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36 months ago
Good Evening Dr. Hansfield,

Just reporting back to you, my HIV antigen/antibody (I'm assuming this is 4th Gen?) test results came back NEGATIVE! You were right!! Thank you for everything you have done, i really appreciate the help you guys provide. I just had another question about Molluscum, after freezing them are they still contagious ? Also if i touch the Molluscum, and touch my face, will it transfer to my face? and yes i know about your websites policy about repetitive, anxiety driven question, been using this excellent service since 2016, you wont hear from me about this again :)

thanks you again, Best Regards!
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
36 months ago
Thanks for the follow-up. Yes, antigen-antibody HIV tests are 4th generation (although the "generation" terminology is no longer official terminology). Of course no surprise that your result was negative, but congratulations.

Contagiousness of MC after treatment has not been researched. But I would guess that frozen lesions would remain infectious for a few days, maybe until healing is complete. Self-infection of a new body site (medical term auto-inoculation) probably can occur but it seems to be rare. Among hundreds of patients with genital area MC who I have personally examined, as far as I know none had facial lesions. It makes sense to use common hygiene, i.e. wash hands after toilet or if they otherwise come into contact with your MC lesions. But probably little risk even if you forget.

Thank you for your kind comments about our services. That's why we're here. Best wishes and stay safe.
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