HPV // Skin tags // Etc.

[andyinnewyork]

This is a bit of a complicated query but I'll try to keep it simple, with links.
I recently went to the dermatologist and got an all clear in my genital area for warts (was just in for an overall inspection for peace of mind.) I did have a small bump or irritation right in the crease of my buttock, however. The doctor said it was a skin tag. This seems reasonable considering the location & the fact that I ride a bike about 10 miles a day.

I asked him if skin tags were HPV-related or contagious. He said no to both.

For better or worse I started researching this online, including a previous post on Medhelp:
http://www.medhelp.org/posts/STDs/HPV-detection-in-acrochordons-skin-tags/show/1748185

That post links to a 2008 study in which skin tags on various body sites were tested for HPV (using 'polymerase chain reaction (PCR) and restriction fragment length polymorphism (RFLP) assays', whatever that is), and found that nearly 50% of skin tags showed positive for HPV6/11, typically the genital wart types.

This other study seems to say that HPV 6/11 is present in 77% of skin tags!
http://webcache.googleusercontent.com/search?q=cache:o9H_z53guMgJ:www.gulfdermajournal.com/pdf/2005-10/3.pdf+&hl=en&gl=us

But the above study also concludes: "No interhuman transmission has been documented, nor viral etiology has been demonstrated, but some recent studies suggest that human papilloma virus
(HPV) may have a role in pathogenesis of skin tags."

Now I'm in a situation where I don't know who to trust, what to do, what to disclose to partners, etc. This 'skin tag' is on the crease of my buttock, in an area that wouldn't really come into play with a partner's genitals during heterosexual intercourse. Should I have the dermatologist biopsy it?? Does the quote & studies above mean that HPV might have some undefined 'role' in skin tags, but that they ARE NOT contagious the way warts would be?

[H. Hunter Handsfield, M.D.]

I have nothing more to say on the topic.

Really, this isn't anything you should be concerned about in the least.  Do try to let it go -- and stop searching the web about HPV.  Anxious people who search the internet typically are drawn to information or viewpoints that inflame their anxieties and to ignore or deemphasize those that should reassure them.  It seems to me that this issue just isn't worth it.

[andyinnewyork]

As always, Dr. Handsfield, you are a terrific voice of reason. Thank you.

[H. Hunter Handsfield, M.D.]

Welcome back to the forum. But you're really hung up on HPV, aren't you?  HPV infections, either in the form of warts or other (usually asymptomatic) aren't worth the level of anxiety you apparently have about them.

It is wrong to simply say that just because conflicting research results have been published, there is controversy about an issue.  Some research studies are more valid than others. Just as there is no controversy about the existance of global warming and that human activities are the cause (despite what you can read in the media), there is none about HPV and skin tags.  The thread you cite in your question gives my concluding advice on HPV and skin tags, that they are unlreateld.  It also includes a citation to a recent study that pretty much settles the issue; that link is also shown below.  

http://www.mums.ac.ir/shares/basic_medical/basicmedjou/2012/may/a7.pdf

In addition to the published literature per se, there is little inherent biological plausibility that HPV could cause skin tags, which (by definition) consist of entirely normal skin tissue; and there is virtually 100% agreement about this among dermatologists and pathologists.  Sure, you can find those who might disagree, just as you'll find the occasional weather scientist disagreeing about the basic causes of global warming.  In both instances, those voices are a tiny minority.

None of the milions of people around the world with skin tags, in the gential area or elsewhere, are ever advised to inform or discuss it with their sex partners.  Neither should you.

HHH, MD

[andyinnewyork]

And one additional query--for something HPV related to be passed on, there would have to be direct contact with the wart, right? Meaning, let's say one had a single wart on the buttock (or a skin tag, if such a thing is actually ebver HPV related)...that wouldn't mean you could pass on 'that' HPV through vaginal sex, right?

[andyinnewyork]

Here's a possible new angle though (and I realize this requires some slogging through material.)

In this 2011 study the authors came to the opposite conclusion of the previous researchers.

http://webcache.googleusercontent.com/search?q=cache:TM1qqqpy2L8J:www.mums.ac.ir/shares/basic_medical/basicmedjou/2012/may/a7.pdf+&cd=12&hl=en&ct=clnk&gl=us&client=firefox-a

The reason they state: "In the present study PCR was done after
pathology confirmation and definite diagnosis
of skin tag, but in the reported studies [i.e. THE ONES I MENTIONED ABOVE]
pathology confirmation have not been done
and diagnosis was made only on the basis of
clinical appearance."

So this seems to mean that perhaps in the 2008 study some of the 'skin tags' being studied were actually just...warts.

Anyway if someone with knowledge on this could spend a bit of time with the links and weigh in on the whole "are skin tags HPV-related" and "are skin tags contagious" angle, based on this literature, I think it would make a good resource (or at least one that's not readily available online...)