[Question #9430] Thank you in advance. Follow up #3323

32 months ago

Hello Dr. Handsfield and Dr. Hook:I will start the thread with my opening from the last time I messaged and say it’s a bittersweet honor to speak to you both! I am glad to see this forum remains active and available to the community for support!I am actually following up regarding a situation that is connected with my first question back in 2018. A quick recap: at the time following my discovery of some small bumps near the anus I was concerned about HPV and had some questions regarding vaccination etc. The results of the biopsy at the time came back negative for both warts and herpes. My doctor was not concerned and stated that non dangerous or non contagious bumps could form in that area and is not a reason for concern. Truthfully since then I was no longer concerned with this and didn’t obsessively continue examining the area for changes or new bumps. Additionally, following the doctor’s assurance I wasn’t concerned if feeling some bumpiness in that area and never felt new or growing bumps. Following a recent look of the area today I was quite distraught to see that visually the bumps looks quite different and unsightly to say the least. The area looks like a cluster of about 8 flat and dark bumps / spots. I have an appointment scheduled with my doctor for next week but wanted to pop in here for the following two questions:1. Assuming this was undetected or undiagnosed warts from 2018 - what is the likelihood that these would have remained or worsened over the course of the last 4 plus years? Other than being a smoker on and off for years I am relatively healthy (35 years old). My understanding is that usually even without treatment these warts would typically clear for most within two years.2. As I prepare for my visit next week I would love to be as well informed on new data and help inform the conversation. As such I was wondering if there are other conditions or tests I should be inquiring about or any other follow up questions to bring up with my doctor

32 months ago

My apologies I meant to close off with thanking you both as always!

Edward W. Hook M.D.

32 months ago

Welcome back to the Forum. On this occasion I happened to pick up your new questions and will be replying. in preparing to respond, I reviewed your interaction with Dr. Handsfield nearly five years ago and agree with all that he said. Several comments:

1. You don't mention whether your insurance or relationship status has changed. Irrespective, my suspicion from the tone of your earlier post is that your situation is low risk.

2. If The fact that you were biopsied in the past in the same area and found to be negative for HPV (as well as HSV) suggests that this will be the case again, i.e. that this process in not HPV. Dermatological processes can evolve and change their appearance. For dermatological processes to change their appearance or change their coloration is not unusual. The right thing to do, rather than assuming that this is HPV, is to be evaluated by a trained clinician as you are doing.

3. In the unlikely circumstance that the "bumps" you noted were HPV, as you know from reading other threads on our site, this is just not a major problem. HPV infections are widespread, typically innocuous and readily managed.

4. If your health insurance status is now changed so that HPV vaccination is a possibility, it would be worthwhile to get it, in part to address your continuing anxiety. The vaccine is now recommended for women up to age 45.

I hope these initial comments are helpful. If their are additional questions or any part of my response is unclear, please use your up to two additional follow-ups for clarification. Please don't worry. EWH

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32 months ago

Thank you, Doctor!

My relationship status is the same and I do have insurance. Thank you for the updated recommendations on the vaccine - this is definitely something I will be following up on and requesting during my appointment.

My anxiety is less driven around it being a new exposure or HPV specifically - more so the longevity of these previously concluded normal bumps evolving into what now does look like dark warts or even something more serious. I haven’t booked a separate appointment with a dermatologist - I have my appointment with my gynecologist on Thursday.

Thank you again Doctor, I don’t think I have any specific follow up questions other than if there are other conditions this sounds like that I should be following up on please let me know if there are specific tests I should request or to book an appointment with another specialist.

Thank you as always.

Edward W. Hook M.D.

32 months ago

Thanks for your follow up comments. I’m glad to hear that your insurance insurance status has improved and that your relationship status is ongoing. When you see your gynecologist, my advice would be to ask her/him to evaluate the lesions that concern you. Equally importantly, I would suggest that you describe for her/him your concerns about HPV and specifically request the vaccine.

Not much more for me to say. I hope these comments are helpful. EWH

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