[Question #4018] HPV
31 months ago
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Hello Doctors,
I apologize in advance for the length of my question here. Just a bit of
background. I am in my late 20’s, have had two full sexual partners in my life
in monogamous relationships for 3+ years each and then after these had brief
hand-genital contact with a third woman. I have been dealing with OCD and
anxiety related to HPV and some bumps I had in my genital area for quite some
time now and I was hoping I could post here my specific situation and get some
feedback from Dr. Handsfield or Dr. Hook because I have yet to find another
situation like mine online.
A
little over two years ago, I got a full-panel of STD tests with everything coming
back negative and then had a doctor (either an NP or PA) at a sexual health
clinic look at a purple spot on my scrotum and then also do an examination of
the entire genital area for any lesions that could be HPV-related and she found
nothing to be concerned about. About 2 weeks after that, I discovered two bumps
on the shaft of my penis that I was concerned with. I will call these bump #1
and bump #2. Bump #1 was slightly larger(about the size of a grain of rice) and
had about 8-10 tiny bumps surrounding it in the folds of skin. Bump #2 was
smaller (about half the size of a grain of rice), itched slightly and had
redness around it and had a tiny bump right next to it. I went to a GP in internal medicine to have
these bumps checked out. She said that she did not know what they were but that
they could possibly be HPV and said she would give me a referral to see a
specialist if they did not go away and still bothered me. I then went back to
the sexual health clinic and had one of the doctors there examine these bumps
under light and magnification specifically (as I believe they were new since
last time I had visited the clinic) and she told me “we see HPV everyday in
this clinic and I really don’t think that this is HPV,” and assured me not to
worry about it.
I was
unable to weigh everything in my mind and move on from this, so I found online
that you can put apple cider vinegar on skin and the skin will turn white if it
is thickened (which I found out later can be thickened from HPV or other
non-sexually transmitted conditions that thicken skin as well). When I applied
the apple cider vinegar to about a square inch of skin on my penis (including
the area with the bumps), nearly the whole area turned white. Bump #2 turned
whiter than the surrounding skin and little red lines (almost like veins)
became visible around it. With so much confusing information thus far, I kept
testing the skin for days and was also trying to see if the bumps would go away
with the application of the apple cider vinegar. Eventually the skin turned
black, bump #2 got “burned” off and some other spots of skin without any bumps
“burned” off as well, leaving little holes in the first layer of skin in these
spots. Within a couple of days, these spots healed and bump #2 that had
“burned” away CAME BACK but was missing the tiny bump next to it that had been
there before (so the main bump was still there, but the appearance was altered
slightly after it got burned off and came back). Bump #1 did not burn off but may
have changed appearance slightly. Although with the way my mind works, I am
unsure if I was noticing a change or just making something up in my head to
scare myself.
I then
decided that taking the situation into my own hands was not helping so I went
to a dermatologist. I got bump #1 (the larger of the two) biopsied only to find
out it was just a skin tag (NEGATIVE for HPV). I have since had two
dermatologists examine the 8-10 tiny bumps around bump #1 and tell me they are
not HPV. The dermatologist also examined bump #2 and told me he was not worried
that it was HPV. I was able to let this go for a while but held off on any kind
of sexual relationship for over 2 years and counting. In the meantime, I had several
other spots on my penis and scrotum examined by several different
dermatologists, only to be told that they were nothing to worry about. About a
year after I first did the “vinegar test” on myself and got the first biopsy
done, I did the vinegar test again on bump #2 (the one that “burned” off and
came back) and the skin did not turn white this time. I went to a different
dermatologist and got bump #2 biopsied and that test came back NEGATIVE for HPV
as well. At the time, I wasn’t sure if the “vinegar test” was relevant, so I
forgot to tell this dermatologist (who biopsied bump #2) about the fact that
the bump had “burned off” and come back looking slightly altered. Either way,
he biopsied it, and it came back negative for HPV.
It has
been a year since the biopsy of bump #2 and over two years since the biopsy of
bump #1. In that time period, no new concerning bumps have shown up on in my
genital area and I have seen other dermatologists only for them to examine tiny
bumps or discolored spots that have been there for a long time. For example,
the redness that I had around bump #2 is still there and a dermatologist told
me that this redness is just a normal variation of skin. Also, it has been
nearly 3 years since I last had any kind of sexual contact.
I realize this was lengthy, just to recap:
1. I had two bumps on the shaft of my penis that a GP said she wasn’t sure about
but could possibly be HPV, but an STD clinic told me on examination were not
HPV.
2. Applying apple cider vinegar to the bumps and surrounding
area turned the skin white. After having applied the vinegar for several days
on and off, Bump #2 “burned off” and came back looking slightly altered. I am
worried that this test may have screwed up a potential diagnosis of bump #2.
3. After having applied the vinegar, I had bump #1 biopsied
only for it to be identified as a skin tag. This dermatologist examined bump #2
and said he thought it was not HPV.
4. A year after having bump #1 biopsied, I had a different
dermatologist biopsy bump #2. This biopsy came back negative for HPV as well.
5. I have had dermatologists examine any other bumps that
may have come up in the meantime and none of them have said they are HPV.
My questions are the following:
1.
I realize that HPV is very common and that many
people do not worry about it, but I am wondering, does this whole experience mean
that I should worry more than the general population that I have or had HPV? The
biopsies and exams kept showing no HPV, but should I put weight in the vinegar
test I did that maybe I did have it? My dermatologist told me that acetic acid
in vinegar will turn any thickened skin white (which can potentially be thickened
for many reasons NOT HPV-related), but I have read online (even on the websites
of reputable medical organizations) that the test helps doctors identify
potential HPV.
2.
I fear that I may have screwed up a potential
diagnosis of bump #2 by doing the “test” with the apple cider vinegar(and
burning off bump #2 only for it to come back looking slightly different). Do
you think the biopsies were an accurate test of whether or not these bumps were
HPV-related?
3.
This question is will be slightly redundant of
the last one: I moved during the couple of years this was all happening and
went to a new dermatologist. I forgot to tell the new dermatologist that
biopsied bump #2 that I had applied the apple cider vinegar to it a year before
and it had “burned off” and come back. While the biopsy did turn out negative
for HPV, do you think this biopsy was an accurate test of whether bump #2 was
or was not HPV-related?
4.
It is impossible to get your entire genital
region biopsied, so what is the best way to make sure that you have gotten all
suspicious bumps sufficiently checked out? (I have heard HPV can lurk in
normal-looking skin as well).
5.
Is there a point when no new bumps arise that I
can assume going forward that I did not/do not have HPV?
Thank you very much for taking the time to answer these questions for me. I
have been dealing with the anxiety related to this through therapy.
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H. Hunter Handsfield, MD
31 months ago
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31 months ago
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Late 20’s, 2 lifetime sex partners.
3 years since last sexual contact.
Background: Had 2 bumps on penis shaft, appeared 2 years ago.
Bump #1: Size grain of rice, 8 tiny bumps surrounding it.
Bump #2: Half size of grain of rice, had a tiny bump next to it,
redness surrounding it.
Went to GP, she said she wasn’t sure, but that the bumps could be
HPV.
Went to a Sexual Health Clinic, the NP or PA told me after
examining with light and magnification “we see HPV everyday and I really don’t
think you have HPV”.
I applied apple cider vinegar to skin at home (identifies
thickened skin, which apparently can be thickened from non-STD reasons or HPV).
Bumps + square inch of skin turned white after application of
vinegar. Bump #2 turned whiter and got little red lines (almost like veins)
around it.
I kept testing the skin for days for acetowhitening and was trying
to see if bumps would go away. Skin turned black, bump #2 got “burned” off
along with some other spots of skin. After healing, bump #2 CAME BACK and
remained until biopsy but was now missing the tiny bump next to it.
Dermatologist biopsied bump #1, skin tag, no HPV.
Dermatologist examined bump #2, told me not worried it was HPV.
Different dermatologist examined 8 tiny bumps around bump #1, told
me not worried about HPV.
1 year after vinegar “test” on bump #2, did test again and bump #2
did not turn white. Then new dermatologist biopsied bump #2, negative for HPV.
Forgot to tell new dermatologist about bump #2 “burning” off and coming back.
Redness around bump #2 still present, but another dermatologist told me normal
variation of skin.
Should I be worried about HPV?
Should I trust biopsies even after vinegar "test"?
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H. Hunter Handsfield, MD
31 months ago
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30 months ago
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Hello
Dr. Handsfield,
Thank you.
You explained: "that a particular skin lesion
returns after biopsy or surgical removal does not mean it's a wart. Many other
things (fibromas and others) can return, especially if biopsy or surgical
removal leaves some of the original tissue behind."
1. My main concern was different from above. I applied the vinegar to
bump #2, it turned white, and then after multiple applications it "burned off," leaving a hole. Bump then came back but it was
missing the smaller bump that had been next to it before. The remaining
bump remained consistent for a year. After a year, I did the vinegar test
again, the bump did NOT turn white. Then I got it biopsied, which came
back negative for HPV. Main concern is that I might have screwed up biopsy and diagnosis of bump #2 by applying the vinegar and having the bump burn off
and come back, because it turned white before it had burned off and did not turn white
a year later when I got it biopsied. Should I worry about this?
2. I forgot to tell the dermatologist that did the biopsy of bump #2 that I applied the vinegar a year earlier and bump #2 had "burned off" and come back. Would his biopsy process have likely been different or should I still trust his biopsy of bump #2?
3. Would there be HPV material related to these bumps that wasn't caught
in the biopsy that I should worry is still present in my skin?
5. Is there a point when no new bumps arise that I can assume
going forward that I did not/do not have HPV?
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H. Hunter Handsfield, MD
30 months ago
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30 months ago
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Thanks Dr. Handsfield,
I might not have explained questions 1 or 2 well enough. The
dermatologists never applied any chemical treatment, they only did surgical
biopsies. The only time bump #2 “burned off” and came back was after I had
repeatedly applied the apple cider vinegar to it.
Sorry if this is redundant but here is my main concern and
series of events as they happened:
A GP said she isn’t sure but bumps could be HPV. A sexual
health NP or PA said “we see HPV everyday and I really don’t think you have HPV”.
First, I applied the vinegar and bump #2 turned bright white with little
red lines visible in it. Alternately, bump #1 turned more of a dull white with
the application of the vinegar. After repeated application of the vinegar, bump
#2 turned black and “burned off” leaving a little hole in the skin for a few
days. After skin healed, bump #2 came back but was missing the little bump it
originally had next to it. Dermatologist said bump #2 did not look like HPV. A
year later, I applied the vinegar to bump #2 again but this time it did not
turn white. I forgot to tell the new dermatologist that I had applied the
vinegar a year earlier and bump #2 had burned off and come back. The new
dermatologist did a biopsy of bump #2 and it was negative for HPV.
Main concern is that by applying the vinegar, bump #2 “burning
off” and coming back and me not telling the dermatologist the bump had burned
off and come back a year before the biopsy, I somehow screwed up an accurate biopsy
of bump #2 and I should still be concerned there is undetected HPV around bump
#2. Should I be concerned about this?
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H. Hunter Handsfield, MD
30 months ago
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