[Question #6928] Possible HPV after exposure

9 months ago
one experience 4 years ago. Vaginal intercourse with female coworker. 10 minutes, break then another 10 minutes (unprotected). High Fever 1 week later, diagnosed with mono. Noticed red streaks on penis, tested negative for all STDs @ 11 weeks. Penile itch & pruritus-ani. Diagnosed with internal hemorrhoids. After carefully observing anal symptoms, two months ago I checked for hemmorhoids internally. I was able to take a picture just inside anal canal where I had a U shaped projection. Was told it is probably a skin tag or some other normal variation of skin. It literally projects out of the soft skin just next to an (what I believe to be) internal hemorrhoid. This was not present in the past from what I had viewed. I do not have any warts on outside of anus. Never had penetrative or same sex experience but have had to use suppositories and am scared I infected this region. What are the odds of internal wart without presence of external anal warts? Also noticed tiny brown spots on penis. other area on shaft almost looks like flat warts, but the dermatologist said he doesn't believe that's what it is. Apple Cider Vinegar didn't show any white spots. 

A Well via doctor prescribed imiquimod just to make sure and I feel like I may have some clearance on the brown spots but still have the spots on penis that I am most concerned of being warts.  One spot may have decreased in size partially.  I did notice last night that I had a red area with a scab on it where my shaft meets my scrotal sac. This was alarming as I have no other spots or anything there. I have not scratched it nor have I been sexually active in the past few weeks with my wife.  

My wife had itching and a small spot inside her vagina that I thought might have been a wart, but it went away in one week. I understand that HPV is normal for sexually active adults. I have had that one experience outside of my marriage, nothing else. 

The dermatologist said he can see what I am saying about my penis as there are like 
9 months ago
lines* that are lines of what seem could be a skin tag. Do warts ulcerate? Would imiquimod make them ulcerate or would it make regular skin ulcerate? I have noticed maybe one or twice a year, I will get what looks like a tiny cut that instantly seems to scab over in the most random places on my penis.  Sometimes it will be on the underside or on the shaft, etc. It won't be there, will turn red like a scratch and then will be gone within a few days.  

My main concern is having a Condyloma inside my anus and if these are warts.  Even with hpv being such a minute thing, I would like to get rid of the warts if that is what it is, as it is psychologically draining.  

1)Does this sound consistent with HPV?

2) Would an anal wart really take nearly four years to project in this manner? 

3) would my body not get rid of the virus by now? If not, could it be that the immiquimod is ineffective for me and my immune system? I was diagnosed with guillarin-barre in 2012, which is classified as an auto immune disease. I fully recovered and underwent IVIG treatment. From my understanding, people with GBS usually fully recover. 
Edward W. Hook M.D.
Edward W. Hook M.D.
9 months ago
Welcome to our former thanks for your question. I’ll do my best to help.  Ano-rectal And HPV infection occurs as a result of direct contact with an infected surface. Thus I single episode of vaginal intercourse would not lead to rectal HPV infections.  Nor would use of suppositories lead to HPV infection.  On the other hand, hemorrhoids and so-called hemorrhoidal tags can commonly be present both internally and externally. My suspicion is that this is what you have seen.

Treatment of possible warts “just in case” is not recommended. The treatment itself can cause its own set of complications. Amongst the complications which occur with Imiquimod are ulcerations, as well as inflammatory reactions.

In answer to your specific questions:
1.  No, this does not sound like HPV.
2.  Typically HPV infections resolve without therapy within a year or two.  As I said above, this really does not sound like HPV.  

I hope this helps.  If you remain concerned, my advice would be to see a proctologist who can help you with diagnosis and, if appropriate, remove these lesions.  EWH
---
9 months ago
Thank you for your response. I knew that most infections cleared up on their own within two years, so I have really tried to bare that in mind. My mind went straight to having an auto-immune disorder and thinking that I may be the rare case that doesn't get them under control.  I think I am going to go to my GP and ask him if there is any type of anxiety treatment that he recommends.  The spots on my penis, coupled with the fact that this girl turns out to have an hpv infection really have done a toll on my psychological well-being. I appreciate you and the rest of the team on here for the support that you three provide. 

I guess I will use my follow up questions considering I paid for them, lol. I have noticed in some of the recent hpv posts/questions on here that it has been said that hpv can be transferred from genital region to genital region via auto-inoculation.  

1) Again , I have not had any type of receptive anal sex, but I have had to use suppositories, as well as apply hemorrhoid cream as well to the inside of my anus. Also, I have checked for lesions etc inside my anal canal. Assuming that I did have warts on my shaft (I know this is not likely as previously discussed) Is this something that could be transferred if I were to check the spots on my shaft then check my anus? I am not sure that I did that, but I do know I have checked my privates through all of this. 

2) Is there a textbook profile or description of anal warts?

3) Lastly, it is my assumption that intra-anal warts would be highly unlikely for someone who has never engaged in any acts involving the perineal region without ALSO experiencing external anal warts.  In other words, in your experience, is it normal for those who have intra-anal warts, to experience them inside only but not externally around the outside of the anus? 


I hope I am still warranted the questions above. If not, I apologize as I am new to purchasing questions. This will complete my conversation. Again, I appreciate your honesty and educated advise!

Have a blessed week.

9 months ago
And I do apologize. I saw the last part you wrote about the proctologist. I actually went to the proctologist who suggested the two prong looking projection was possibly just a skin tag. He went ahead and used what he called a "nitrogen stick". This hurt and still does hurt 5 days later. He said he went ahead and used the nitrogen on it to ease my concerns. 
Edward W. Hook M.D.
Edward W. Hook M.D.
9 months ago
I believe you have misinterpreted some of our replies to others.  Transfer of HPV from one part of the body to,another on,a person’s hands is exceedingly rare.   Not that you have transferred HPV from your penis (if what you have noted Is HPV) to your rectum through use of suppositories and hemorrhoid cream.

Anal warts are highly variable an appearance. Determining whether or not the lesions that you have noted are due to HPV should be left to an experience the clinician.  But this is what you describe however does not sound at all like HPV.

3.  Once again, I am not ready to except your premise that you have into anal HPV.  The fact that the colleges you saw felt that what you were concerned about was not a word is further evidence that this is not the case.

You have one follow-up question remaining. Feel free to use it if any of this is unclear. That said, I believe that you are worrying unnecessarily. I hope that my comments have been helpful. EWH
---
8 months ago
Doctor, for my final question(s). 

I found peace in your last reply. However, I went back for a 3 week follow up regarding the banding of my hemmorhoids and the removal of a growth on the dentate/pectate line, which the doctor said he thinks could just be a skin tag. This spot had two projections on it and looked almost like a tooth or a sticker. . After the digital exam, I left the appointment with pain in the anal region. 

Fast forward to 5 days ago, I noticed a parasitic worm wiggling around inside my anus as I noticed some mucous in the TP after wiping. I bought treatment for this at Walgreens and it's been 5 days since. Last night I past gas more than 40 times. This afternoon  I recorded myself checking my anus for any worms or more hemmorhoids. When opening up the canal, it looked normal, then all of a sudden. A rush (large amount) of white mucous pushed through the canal followed by a small amount of liquid stool (I do not have diarrhea). 
I still have some pain where the doctor used nitrogen for the internal spot nearly one month ago. Given this is my last question. Could you please provide me your thoughts in depth on all of this.  I had spots on my penis, the imiquimod seemed to get rid of some of them but those black/brown bumps came straight back. As far back as I can remember, I have had anal itching and itching on the penis shortly after the one time sexual encounter back in August of
2016. I am married with kids and am terrified of what this could be.  By the way. My wife has not had an abnormal pap as of yet.  Thank you doctor. 
Edward W. Hook M.D.
Edward W. Hook M.D.
8 months ago

Once again, I think that you are over reacting in attributing these symptoms to your prior sexual mis-step.  Trying to guess what might be going on here would be inappropriate, in part because this is not an STI and in part because you may need formal testing.  My final suggestions:

1.  The increased gas and mucous could be because of the treatment you sought of a non-STI parasitic infection.  See your doctor.

2.  Anal or genital itching in situations such as yours is often due to the tendency of persons who are looking for signs and symptoms to detect what are otherwise normal sensations which are typically overlooked.  This sort of mis-interpretation is a manifestation of the search for signs of infection and on occasion, guilt and/or anxiety.  Please do not worry about this.  The same goes for the "brown spots" you have noted.

I hope these final comments are helpful. These final comments complete this thread which will be closed shortly without further replies.  There should be no need for further questions related to your mis-step.EWH

---