[Question #4506] Follow up to #3733 HPV

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81 months ago
I visited my dermatologist for an unrelated skin issue in June.  He looked at the area where the wart was and treated the area with acid and said it was seborrheic keratoses and not a wart.  I visited him again last week for skin issue on hand.  He looked at area with his magnifier and said he saw 1 or 2 small bumps that appear to have been a wart.  I hadn't noticed it. He froze the area.  Assuming the seborrheic keratoses in june was not a wart, it has been 14 months since original treatment.  Is this unusual to  go that long without recurrence and then have one.  Does this make the "most cases clear in 2 years" statement unlikely to be true in my case?  I do understand the uncertainties of this from your last answer, but looking for your opinion.  I have not had sex since last November so not new infection.

I'm a non smoker, but do things like diet, alcohol have an impact on this? 

It had been long enough since first treatment that I was ready to start dating again.  The thought of passing this to someone else is horrifying.  What would be a reasonable time frame without another recurrence that I might consider myself to be safe again?
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H. Hunter Handsfield, MD
81 months ago
Welcome back to the forum. Thanks for your continued confidence in our services. I happened to be logged in when this question arrived:  most users shouldn't expect nearly real time replies!

I laughed out loud when I read the second sentence and I'm still smiling as I type this reply. I had just re-read our previous discussion, and was clucking my tongue because I realized I failed to mention seborrheic keratosis as a possibility. SKs are increasingly common in all people as we age beyond 50 or so, and they are the most common wart-like skin problem that isn't really a wart and not caused by HPV. And then I started this thread, and there it is!

To be honest, I also tend to doubt the two new bumps found by your dermatologist are warts. Visual diagnosis by a dermatologist usually is correct, and I'm not challenging his expertise. But he will also tell you it can be quite uncertain for lesions small enough to require magnification to examine clearly. If any doubt, it was reasonable to treat them with local freezing. But my guess is he isn't all that certain about the diagnosis. 

Your diet or alcohol habits are unrelated to all this. To the extent diet, alcohol, drugs, exercise, stress, and adequate sleep can affect the immune system, there is no known effect on HPV or warts. Smoking may be an exception:  in women, abnormal pap smears caused by HPV clear up more slowly, and development of cancer is somewhat more common, in smokers than nonsmokers.

Certainly your seborrheic keratosis is not transmissible sexually or by any other contact. Even if the two new spots indeed are warts -- as I said above, they may not be -- I don't think you need delay at all in initiating a new sexual relationship. In our last discussion I went into quite a bit of detail in explaining why you are not likely to transmit HPV to any new sex partners. I can't say the risk is zero, but you can safely assume your partner(s) have had HPV and, depending on their age, may still have dormant or active infections. Even if you have HPV, such women are unlikely to be infected by you; and if they are, probably will never show symptoms or have any health problems. Please re-read our previous discussion. And remember that genital HPV is a normal, expected, and mostly harmless consequence of being sexual. 

For clarification, you might consider printing out this thread and showing it to your dermatologist. I'm betting he'll agree with all I've said.

I hope this information is helpufl and reassuring. Let me know if anything isn't clear.

HHH, MD
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81 months ago
After rereading the sentence, it could have been better written!  The SK treated in June and the cryo treatment were both is the same place as the original wart.   Is there any correlation?  The skin in the area is raised and has been this way since original treatment.

Thanks for your response.
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H. Hunter Handsfield, MD
81 months ago
OK, thanks for the clarification. I'm betting the original lesion was a seborrheic keratosis and not a wart. But you would have to discuss that possibility with the dermatologist. In any case, this doesn't change my opinons or advice.---
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81 months ago
Are you saying the original diagnosis by urologist in August 2017 may not have been a wart or the second treatment in June for SK by the dermatologist? Understand the most recent diagnosis with magnifier may not have been.  The original treatment in 2017 and the treatments in June and October of 18 were all in the same spot.  

To be clear, assuming a new similar aged partner, they are unlikely to be infected by me even if I did have a recent wart?

I have to see dermatologist again in December for another skin issue and will ask him.  
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H. Hunter Handsfield, MD
81 months ago
I wasn't there and I'm not going to try to compete with your urologist for the correct diagnosis! All I'm saying is that based on your description and all the information you have provided, I am suspicious you never had warts, only one or more seborrheic keratoses. Many skin conditions other than warts, including SBs, often recur at the same spot.

And yes your comment about your partner and the likelihood of infection, or of visible warts, seems low.

Getting another opinion from your dermatologist is exactly the right thing to do, as I suggested above. I also suggest you print out this thread as a framework for discussing these issues with him.

Having had two follow-up comments and replies, that concludes this thread. I hope the discussion has been helpful.
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