[Question #8] Second opinion needed?

41 months ago
Hello,

I'm going to try and make this as short and sweet as I can!

A couple months ago I developed a bump in my pubic region. I blew it off thinking it was an ingrown hair and didn't think anything of is since I've been with my fiancé for over 3 years. The bump never went away so I decided to go to the doctor fearing it was genital warts. Had no idea HPV could remain dormant in your body for years and never show any symptoms of it. Needless to say, I was terrified. Obgyn said she wasn't convinced it was HPV but I developed a couple smaller bumps that were similar so I had convinced myself it was. She took a biopsy and off I went with this constant fear for the next 6 days awaiting my results. 

Come day 4, I noticed several flesh colored bumps on the very back of my tongue. Not painful but annoying.  To say I freaked out is the understatement of the year. I was now 100% convinced I had HPV down there and now oral HPV. Side note, the evening I developed the tongue bumps I had two glasses of red wine, which I normally don't drink, and ate salmon, which I haven't eaten in 20 years. 

Finally heard from the doctor that the biopsy came back as Molluscum Contageiosum (sp?) and not HPV. I was relieved but still had the bumps on my tongue and scheduled a follow up appt. Not sure how I got MC but know it is very easily picked up from many things. But read that typically in adults, it's contracted via sex but my partner doesn't have any.  I have two kids so maybe one of them brought home something? Also went to Mexico a couple months back and you just never know since it's spread via towels, washcloths, bedding, etc. We did have sex on a public beach at night on a lounge chair...

She took a swab of the back of my tongue and it came back as "negative for viral and negative for malignant cells." She said this was good news and to go see a family practitioner for my tongue. 

I should be relieved. I should be happy. But I guess I am playing devil's advocate since my tongue is still the same. 

My questions are: should I have a second swab done just to confirm? I mean, I want to COMPLETELY rule out any STD possibility in my mouth. Is that what "negative for viral" means from my results? Also, should I be seeing a dentist or ENT rather than a family practitioner? I'm scared she didn't swab enough or something. Internet research rendered enlarged circumvallete papillae (sp?) possibly but I'm just dumbfounded as to what it could be and always fear the worse. For more than two weeks, I haven't been able to eat, sleep without the aid of Benadryl, or think about anything but this. I know stress can do a lot of strange things to your body and I've never been so stressed in my life. Perhaps that's why my tongue isn't getting any better? Also, I do drink beer and use an electronic cigarette. Perhaps that's not helping either??

Please help!

THANK YOU IN ADVANCE. 

H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
41 months ago

Greetings. Welcome to Ask the Expert and for your question. I think I can help.


As you may already know, molluscum contagiosum is very minor condition. It is entirely without serious outcoms or complications, and it clears up entirely, never to return. Even if new lesions appear over the next few weeks, they can be easily treated by scraping them away; or you can learn to open them with a needle and express the hard white core.  That cures each bump. Anyway, they’ll soon stop recurring. Sorry you had to go through the uncertainty of worry about genital warts.


As for your tongue, my guess is nothing is wrong. I’m pretty sure you have just observed your circumvallate papillae, which often aren’t noticed until someone has reason to look. Ask your doctor — or take a look at someone else’s tongue, maybe your fiance’s. Probably you’ll find the back of your tongue and his look no different. MC rarely involves the inside of the mouth, and no STDs would cause bumps like you have seen. (Warts also are very rare in the mouth.) And the chance of oral cancer at your age is just about zero.


In other words, I’m pretty sure nothing is wrong at all, and even more certain you have no oral STD, cancer, or pre-cancerous problem, and I see no need for any additional testing of any kind. I really don’t think you need another medical opinion, but if you would like a final reassuring exam, an ENT doctor would make sense. Or your dentist, who of course is an expert in recognizing oral and throat problems.


I hope this has helped. Best wishes.  HHH, MD




---
41 months ago
Dr. HHH,

Thank you so much for taking the time to reply and help put my mind at ease. I still have bumps today, and they unfortunately don't look like anyone else's, but I'm taking a probiotic, B12 and gargling with sea salt. Hoping those online remedies will help!

Just to confirm, the "negative for viral" means no viral STD, correct? And "negative for malignant cells" means no cancer, right? I just want to make sure I'm understanding the swab results. 

Again, I always fear the worst but have a doc's appt next week and will just try and wait this out, as difficult as that is! But it is reassuring to hear you doubt it's an STD or oral cancer. 

THANK YOU AGAIN!
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
41 months ago
I'm afraid probiotics, vitamins, or gargling salt (or anything else) are not likely to make any difference in clearance of molluscum. But they certainly don't hurt, and might help promote vaginal health, so fee free.

I don't know exactly what test was done from your tongue or throat. "Viral" could be many different things. As a guess, maybe an HPV DNA test? Or culture or PCR test for HSV (herpes)? If so, these test only for those particular infections, not for any other STDs that could infect the oral cavity. However, the risk of those is simply to low to be a concern -- unless you suspect your fiance has had other sex partners. If you do suspect that, however, getting tested yourself isn't the way to go. If so, he should have STG testing, such as urine test for gonorrhea/chlamydia and blood tests for syphilis and HIV (but nothing else).

"Negative for malignant cells" means a pap test was done and didn't find cancer.

I don't just "doubt" you have an oral STD or cancer. I am absolutely certain. If you had been evaluated in my clinic, we would never have done the tests you have had, and wouldn't have done them even if you requested it!

I don't mean to sound insensitive, but you really are overreacting -- presumably because of anxiety engenered by the initial surprise when this problem first arose. Truly, you shouldn't be at all worried!
---
41 months ago
Yes, I am completely over-reacting, I know!

The pills and sea salt are actually for my tongue so praying that will help. 

All I had was my tongue swabbed and those test results were from that alone. Assuming by the results of no viral and no cancer, I should be okay. 

Thank you again so much. You really have helped me feel much better! I am guessing that stressing about having something so serious for almost three weeks straight is why my tongue issue isn't going away! Maybe this email exchange will help. Thank you again!
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
41 months ago
I'm glad to have helped. We're at the follow-up comment limit (2 follow-up comments or questions), so that will end this discussion. Best wishes.---