[Question #3428] Final Followup to 3258

37 months ago
Drs,

Your help throughout this ordeal has been priceless. 2.5 months ago I had an exposure where I fingered a dancer at a strip club for several minutes and then masturbated myself a few moments later. I understand this is low/no risk. After a series of tests, I am confident with the tests and your words. At 8 weeks, I did a final full panel (HIV duo and all STDs (chlym, gon, syph, HSV 1/2, Hep a,b,c) and it was negative.

However, my only remaining fear is HPV. I've read the scientific literature and the countless posts here so I'm not looking for probability or chance (I know it is low), but rather my question is what do I look out for? I've noticed for about a week now that the proximal nail fold of one of my fingers that was in contact with the dancer is discolored (lighter in color) in almost a half-moon shape, with the base starting at the skin right above the nail and working its way up in a parabola. There's a distinct line around the entire region. Its especially evident after taking a shower (the skin in that region also tends to peal away a little more easily after the shower). It is painless, but no other finger has this. I'm seeing a derm in a few weeks but wanted your opinion as well. I have yet to resume sexual activities with my wife because of this. I am over 29, but neither of us have ever gotten the vaccine.

I know this is my 3rd question in the span of 6 months, so if it is deleted, I'll consider this a donation for the wonderful work you do. Thank you.
Edward W. Hook M.D.
Edward W. Hook M.D.
37 months ago
I will not delete this questions (yet) but remain disappointed that you felt the need to return to the site.  The "ordeal" you have gone through reflects you guilt over the event, as opposed to any meaningful risk for any STI, including HPV.  As a sexually active adult, as you should know from the other posts on this site you have looked at, you most probably already have HPV and nothing will come of it.  Nor will you transmit it to your wife.  HPV infections, unless they lead to visible warts, are typically asymptomatic.  They do not cause discoloration of the sort you describe. 

You really need to move on from here. I urge you to do so.  As indicated by your posts, it seems to me that the most effective and efficient way to accomplish this is to see that input of a trained counselor or mental health professional.  Such services are confidential and, I believe, have much potential to help you move forward.  EWH
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37 months ago
Thank you for your reassurance, Dr. Hook. My wife and I are each other’s firsts, which is why I’m especially nervous. I’ll take your advice and start seeing a counselor for my mental health. I’ll also refrain from google...some of the images of warts on fingers show discoloration and a distinct borderline that I explained so that just added fuel to the fire. But I trust your advice over these so I’m laying the discoloration issue to rest.  

Thanks again
Edward W. Hook M.D.
Edward W. Hook M.D.
37 months ago
Thanks for your faith.  I think your plan is a good one.

Just as an FYI, there are over 100 different types of HPV.  Different types have a predeliction for different sorts of skin.  The types that cause genital infection rarely cause infection of the hands and feet and vis versa.  I suspect that the HPV that caused the lesions you saw on line were not the same type that cause genital infections, including genital warts.  EWH
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37 months ago
Thanks for the "FYI", Dr. Hook. Seeing as this will be my last comment on this board (and I thank you for allowing this conversation), I just have one last question. On this same finger, outside of this "discolored" zone, I have a single tiny white spot thats deep to the skin. It's about 1-1.5mm in diameter, circular in shape. It only becomes noticeable after showering or when putting on hand lotion. The spot has been there for about 2 weeks, but it seems to be getting more evident. It is not a bump and is clearly under a few layers of skin based on how you look at it. I know its weird, but directly looking at it, it seems to be under my skin. When looking at it from an angle, it seems to be higher up (but still under a thin layer of skin). I don't have a similar spot on any other finger. Does this sound like a flat wart to you? I'm almost tempted to just remove it with a needle/pin.

Again, thank you Dr. Hook. Per your advice, I'm seeing a counselor this week. Thanks for all that you do.
Edward W. Hook M.D.
Edward W. Hook M.D.
37 months ago
The further discoloration you describe sounds nothing like a flat wart of any sort.  Flat warts occur in healthy skin and do not change color when exposed to water or soap and water.  There may be some sort of sub-surface damage from other trauma/processes or dermatological problems but there is no STI which would explain such findings.  Your description however does suggest continued excessive self-examination.  This makes me all the more pleased that you will be seeing a counselor.  You might print out this and our last interaction to help demonstrate to your counselor while you have sought their input. 

As you point out, this completes this thread which will be closed later today.  Take care.  EWH
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