Do I have genital warts?

[typo231]

Hello,

I'm a 29 y/o uncircumcised male. I'm concerned about a protuberance I have on my penis. It's sort of a line that goes along the lower rim of the glans, but a few milimeters lower, and only on the upper side of the penis, not under where the frenulum is. It's not easily visible; when the skin is stretched it's more noticible and kind of looks like a scar.
There also are a few bumps scatterd along the line.

I know I've had this for quite some time, but I don't know if it has always been there or if it appeared at some point.
It doesn't change, grow nor becomes more apparent.

Anyway, I'm worried that it might be genital warts. As I said, it's hardly noticible and I had never paid any attention to it before. I've been checked by a few doctors and urologists and they've all said I'm fine. I explicitly asked one of them about it and he simply said: "that's very common in uncircumcised men".
I, however, don't trust these doctors' opinions very much because I've found that they are fairly ignorant when it comes to std's. I live in South America.

I've also heard that that's a very common location on the penis to find genital warts.

So my questions are:

Could this be a mild case of genital warts?
Do genital warts always grow, or can they stay small indefenitely?
Does the fact that it doesn't change discard the possibility of genital warts?
If it's not genital warts, what could it be then?

Thank you.

[Edward W Hook, MD]

1.  Visual diagnosis varies in accuracy, depending on the appearance (some warts are classical, others are not) and the expereince expertise of the clinician.

2.  Biospies can be done and are reliable.  It may or may not be needed, depending on the factors mentioned in 1 above.

3 and 4.  Treatment is destructive and non-specific.  Just beausue somethign goes away does not mean that it is a wart (or not).  EWH

[typo231]

Good day Doctor,

a few other questions have arised:

What can be done if doctors cannot be certain about a visual genital wart diagnosis?
Can a biopsy be done to see if there's HPV present?
Can some kind of treatment be initiated to see if it's effective?
Would the effectiveness of the treatment confirm a GW diagnosis and vice versa?

Thank you very much.

[Edward W Hook, MD]

It is not uncommon to have small "skin tags" associated with the foreskin.  Perhaps this is what is going on.  EWH

[typo231]

Thank you Doctor for your response.

Just one more thing, I forgot to mention that this protuberance that I have is located where the foreskin folds. This might be the cause. Have you heard about anything like that?

Again, thank you.

[Edward W Hook, MD]

I am sorry, without the opportunity to examine you I cannot offer an opinion as to what the bumps you have noticed might be. That is something that you need to be examined to determine.  It sounds however as though you have been examined and based on what you tell me, if you have been seen by several doctors who say they are not warts, then they probably are not.

There are several other sorts of irregular skin lesions which can occur on the penis is the area you have describe. One is called "pearly penile papules" which are benign, normal skin lesions. These can vary in appearance.  Alternatively, there are several glands that may be apparent at head of the penis and benign cutaneous cysts can occur as well.  Perhaps one of these is present.  In answer to your specific questions:

1.  Seems unlikely, as I explained above.
2.  Genital warts can remain the same size for long periods of time..
3.  It really doesn't change things one way or the other.
4.  See above.

I hope my comments are helpful.  Unless they change, they really do not sound like something to worry about.  EWH