[Question #4022] Possible wart and assessment help

30 months ago

Hi Dr. HHH/Dr. Hook


I was asked not to ask any further questions after # 3525, so I have refrained from doing so. I have not had any new exposure.


  1. I saw few closely spaced bumps on my foreskin which a STD RN said might be warts and asked me to confirm with a dermatologist. The derm looked at them and said that they are most likely sebaceous glands or fordyce spots, since she could see a yellowish tinge to them. 
  2. The red bumps/splotches near my meatus opening which I mentioned in my last question still worry me little since they sometimes become more red and I see more of them. I showed them to my derm, but they were not that bad on that day. He mentioned that he hasn't seen something similar earlier, but it seemed something normal like blood vessels to him, and that they can become more prominent due to sex or masturbation.
  3. I still have random pain in my urethra or penis sometimes, I saw a Urology RN at Stanford. As Dr. HHH indicated in my last post, RN mentioned CPPS and asked me to exercise, take warm baths etc.

Do you agree with the assessment reg. Warts and red bumps? I am scared to get biopsy done since foreskin is very sensitive.


I am also little concerned about HSV. I tested at 16+ weeks for common STDs. But I have read that some people never seroconvert for HSV. Also, I have lower back pain and had another bump in groin area which GP said was folliculitis(though no hair).


Thanks!

30 months ago
Also I had undergone 3 weeks course of doxy 100 mg. 2X day during weeks 11-14 due to a tick bite. Do I need to retest, since tests were done 2+ weeks after I stopped taking doxy?
30 months ago
sorry Drs., one last thing- I have had pain in lower abdomen or just above my penis for last 2-3 weeks, The GP did a urinalysis which showed trace of leuks. and blood in dipstick. The follow up microscopic urinalysis done was normal. Is trace of blood normal?
Edward W. Hook M.D.
Edward W. Hook M.D.
30 months ago
I'm sorry you continue to worry about possible STIs from your prior exposure.  I am also sorry you felt the need to return to our site.  Much of what you mention here is repetitive and rephrasing of problems you described in your earlier interactions you had with Dr. Handsfield.  My responses on those topics will be brief. 

1&2.  All too often when untrained persons see "bumps" and irregularities on their genitals, they worry about HPV/warts.  This assessment is often off target.  What you describe does not sound like warts to me.  You have been examined by a trained medical specialist- your dermatologist..  I would believe your dermatologist. 

3.  You previously describe your random pains to Dr. Handsfield.  He indicated that it did not suggest STI.  I agree. STI symptoms do not come and go.

I see no reason to worry about HSV.  You have not had an outbreak, your tests are negative and your exposure was low risk since HSV is rarely transmitted through a single exposure. 

No need to repeat your tests.  They would not be impacted by your doxycycline therapy. 

As Dr. Handsfield indicated, many persons have trace leukocytes present and this is not a sign of STI.

My sense is that you are overthinking this and need to put your concerns aside.  I trust you will not follow-up with further repetitive questions.  The answers are not going to change.  There is no indication that you acquired an STI.  EWH
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30 months ago
Thank you so much, Dr. Hook.

I just have one remaining question- there has been sort of 'balanitis' on my penis head, under the foreskin which I had talked about in my earlier interaction with Dr. HHH. My dermatologist swabbed it for bacteria and it came out with 4+ Proteus Mirabilis. , 4+ Enterobacter aerogenes. I was prescribed gentamicin ointment. The area looks better now, but it sometimes gets worse. I have been asked to follow hygiene and cleaning instructions since I am uncircumcised. My dermatologist wasn't able to provide a specific way in which I could have acquired those bacteria. Have you seen this in your patients? Can I pass this to a sexual partner ?

I would just like to thank you and Dr. HHH once more. This is an excellent online resource, and it is probably the best of it's kind across all fields, and am sure will be helpful for generations to come. I think Dr. HHH has mentioned that the search functionality on this site will be updated, if that happens, it will just be awesome. Thanks for all that you do.

Edward W. Hook M.D.
Edward W. Hook M.D.
30 months ago
  All persons have bacteria present on their skin. In particular, For uncircumcised men of the foreskin provides a moist dark environment which is ideal for bacteria to grow.  Enterobacter and proteins  bacteria are common in the genital area. The presence of these bacteria under your foreskin does not suggest that they are causing harm or an infection. Furthermore these bacteria would not be expected to be transmitted To partners or cause harm for sexual partners.   I would not let the results of this culture concern you. I would however encourage you to follow your doctor's instructions regarding keeping the head of your penis clean and dry.   EWH---
30 months ago
Thanks a lot, Dr. Hook. I had another bump show up in my groin area, which the doctor suggested was again folliculitis. I did not use to get these earlier, so it concerns me a little. I won't ask repetitive questions, just had one query. I have seen that earlier the suggested time to wait for HSV WB was 16 weeks, but now in few posts I have seen that the suggested duration is 12 weeks. Is this correct? I am about to enter a new long term relationship, and wanted to make sure that I am in the clear and can resume unprotected sex with confidence.
30 months ago
Also Dr. Hook, I recently developed a wart on my face. I had another wart on my neck last year. Is it also possible to get genital warts if someone receives a full body massage while being naked? (no happy ending involved). Or are only non genital wart types spread from things like towels, etc.? 
Edward W. Hook M.D.
Edward W. Hook M.D.
30 months ago
Final responses.  You are over reacting.  There has been no evidence that you have an STI yet you continue to be hyper-vigilant in a way that is not good for your mental health.  Folliculitis is a common occurrence which often goes unnoticed.  I suspect that is what is going on. 

Recent data has allowed us to assure clients that if persons are going to develop antibodies to recently acquired HSV infection they do so by 12 weeks rather than the 16 weeks we stated in the past. 

There is no apparent reason for you to abstain from unprotected sex with a partner without concern about transmitting an infection to that partner. 

Warts occurring on non-genital sites are typically caused by different types of HPV than genital warts.  Transmission of HPV through massage is rare.

This is my final response to your questions.  There will be no further replies.  In addition further anxiety-driven questions may be deleted without any response and without return of your posting fee.  Please try to relax and move forward without further concern.  EWH
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