[Question #7476] Bowenoid papulosis lesions

2 months ago
Doctors I’m crying  right now because I think my sexual life is over.
I’m a 22 year old 4th year med student and i’m Middle Eastern.
I have been sexually active in my highschool years with girls in my class. I always used protection. Every single time
I even got tested every year from 16 yrs old till 19.
After my second year of college I stopped having sex completely. I was trying to find the girl I’d marry and fall in love with. 
Now between the break of Covid-19 I had 1 protected sex with a girl I used to hang out with and it was with protection- this was in may- 

After that I met this girl who is everything I want, she has been with only one partner and she left him 2 years ago. 

We didn’t have sex till two months ago, everything was fine till she removed her underwear where the smell was terrible. I also had white chunks on my finger after fingering her. Never saw this before, and she bleeds easily while having vaginal sex.
Had sex with her twice then got busy with my studies.
After 5 weeks of meeting her I saw a flat bump on my shaft, it doesn’t have any pain whatsoever. I thought it was some sort of balanitis. But after remembering everything I panicked. Kept googling for a while and I decided to go get a full STD checkup yesterday. I talked with the dermatologist of the clinic and he examined me, he said he’s 95% positive its not HPV but he can’t guarantee. He told me to just keep an eye on it see if more show up but I insisted on getting a biopsy.

He brought a blade and kept scratching the skin above it, the used a cotton and swabbed above the scratched area. - Is this the correct method?- 

He told me that these tests are not very accurate so I should keep an eye on it and see if it didn’t go away with time he’ll laser it.

I’m 100% sure its bowenoid, what should I do? I don’t want my sex life to end. I don’t even get aroused anymore due to the shame I have
Edward W. Hook M.D.
Edward W. Hook M.D.
2 months ago
Welcome to our forum.  Thanks for your questions.  I’ll be glad to comment and offer some perspective.  You have been examined by a trained clinician who has told you that the bump you noted is unlikely to be HPV,, much less bowenoid papulosis. Mother time frame of your recent exposures is not suggestive of any HPV infection since it typically takes about three months for genital warts to appear.  What you describe is more suggestive of a seborrheic keratosis or other benign, non-STI dermatological process than an STI.  

I should add that the findings you have noted in your recent partner are in no way suggestive of an STI.

My advice is to take a deep breath, believe the dermatologist you saw, and work with him/her prospectively to sort this out.  In an unrelated fashion, if you have not yet gotten the HPV vaccine, given your concerns, you should.

I hope this perspective is helpful.  Please don’t worry.  EWH
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2 months ago
Thank you for your reply doc.
I just don’t know if this is the correct way of taking a biopsy of the lesion? ( as I described  in my main question)
I’ll get my results back in 1 hour.
I’m also thinking of using aldara 5% on the lesion and see if it would help even though I’m not diagnosed . Do you agree? 
+ What if it was a high risk HPV wart will it ever go away and I stop being contagious?
Regarding the HPV vaccination, no I haven’t got any. Will it be effective even though I’m 22? If this is HPV( I hope not) will it help keeping it dormant?
Last question before getting my results, if I vaccinated my future wife will she ever get HPV if I had it? Thank you
Edward W. Hook M.D.
Edward W. Hook M.D.
2 months ago
A shave biopsy is a widely used, appropriate technique for performing biopsy of the lesion you describe.  If this is Bowenoid papulosis or other HPV related process, this biopsy will show it.

I urge you not to initiate treatment without knowing what the lesion is and whether or not it even needs treatment ment,  Aldabra is irritating and has side effects.   As a physician in training, you should appreciate how misleading unwarranted treatment can be!  

Vaccination will be highly effective for you at age 22 and vaccination for you and your future wife will prevent acquisition of the vast majority of new HPV infections, if exposed.  

Let me know what the biopsy shows and I may have further comment.  EWH 
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2 months ago
Hello again doc,
Couldn’t reply because my swab results was pending and it turned out that I’ve got gardnerella vaginalis, pretty sure its from the girl I’m talking to right now.
I talked to her and she started crying and told me she didn’t know she had anything and I said it’s okay since its not an STD.
Everything elce came back negative 
HSV (IgG/IgM + Pcr)
HIV(Ab/Ag + PCR)
HBV(PCR + HBsAg)
HCV(PCR + Anti HCV)
Syphilis(VDRL+TPHA)
Trichomonas
Gonorrhoea 
Chalmidya 
Candida 
And other bacterias

The HPV biopsy result was negative for All the subtypes they tested for especially the ones that scared me (16,18) 
The doctor told me keep an eye if new bumps will appear and I’m okay

I’ll get vaccinated tomorrow for HPV

Should I stop worrying? And can I continue having sex after my first vaccination dose? 
Or should I inform my future partners if I had any that I may have HPV? 
I’ll test every 6 months from now on


2 months ago
Forget to add they I went down in girl back in time.
Should I get a throat swab? Thanks!
2 months ago
One last thing so everything becomes clear to you doc
The HPV TEST was a urine + the swab from the lesion

Edward W. Hook M.D.
Edward W. Hook M.D.
2 months ago
Your Results are entirely negative. Gardnerella is not an STI and is a normal part of the genital  microbiology. Your tests are entirely negative.

Congratulations on your decision to get vaccinated for HPV. I recommend that your partner do so as well.

Cunnilingus Rarely leads to acquisition of an STI, even if your partner is infected and your partner is almost certainly not. It is time for you to stop worrying, to move forward without concern, and try to repair your relationship with your partner.

I hope my comments have been helpful. EWH 
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Edward W. Hook M.D.
Edward W. Hook M.D.
2 months ago
there are now three replies to this thread. Therefore, as per Forum Guidelines, this thread will now be closed.  EWH
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