HPV/Wart?

[fear911]

Hello Dr. Handsfield,

What does this look like to you?

http://www1.picturepush.com/photo/a/1192454/img/Anonymous/image.jpg

The bumps are at the base of my penis and my scrotum.  None on my penis shaft.  I started shaving my scrotum and genital area about 6 months ago and got a lot of ingrown hairs.  I tend to pick at the infected area often and don't let it heal properly and I also sweat alot from working out and not showering immediately after.  I know it's bad.

I have been shaving this area pretty regularly now since then with a razor blade and usually just soap and water in the shower.  I was first worried that the bump in the picture might be a wart about 4 months ago and had it checked out at a local STD clinic.  The clinician (I don't know his credentials) told me to leave it alone for a few days and stop worrying and that it was just foliciulitis from shaving and picking makes it worse.  I would leave it alone for a day or two, it would get better, and I then I'd start picking at it again.  I also tried applying polysporum ointment.  I had been picking at it a lot when I took the photo.  I also masturbate very frequently.  (another problem)

It appears that there is a hair at the base of it and the other bumps.

I went back to the STD clinic yesterday and was told that it might be a wart but he wasn't sure.  He told me to go to a dermatologist.  I intend to do that right away but was looking for your help until I see a doctor.

Any idea if it is HPV/Warts?  If it is, does the fact that I first noticed it several months ago count towards the 6 month time frame for clearing the infection?  I've only have unprotected sexual intercourse with one girl in the past 12 months but I'm not longer with her, although I have had oral sex with one other girl one time.  

Thanks for your amazing help and advice.  I am still panicking but not as much today.  I want this cleared up immediately so that I can move forward with one girl with a clear conscious.

[fear911]

A related discussion, Advice was started.

[fear911]

I think I might have figured out what it is:

http://www.visualdxhealth.com/adult/lichenSimplexChronicus.htm


Are you familiar with this condition?  I am obviously still going to go to the dermatologist but this is exactly what it looks like.

Thanks again Dr. H!  You are a precious resource to the medical community!

[H. Hunter Handsfield, M.D.]

That wording -- "something more ominous" -- probably is code for cancer.  There is nothing in your description that suggests it.  Further, like the large majority of skin cancers, those in the genital area usually are very slowly invasive and are easily cured by simple surgical removal or chemotherapy creams, without requiring drastic treatment like amputation (e.g. of the penis).  This isn't something to lose sleep over.

[fear911]

Thank you for your prompt response Doctor.  I am very appreciative of it.

Quick follow up question though please- do you have any concerns that there is something more ominous lurking behind this (these) lesions?  If you had to guess?   I recognize that I can't rely on anything that you post in this forum but your opinion would partially set my mind at ease further until the appointment.

With sincerest gratitude and respect.

[H. Hunter Handsfield, M.D.]

Thanks for your thanks about the forum.  Unfortunately, with apology, on this forum Dr. Hook and I do not view posted photographs.  In our view, it comes too close to practicing medicine from a distance, which we cannot do.  Also, we are not dermatologists and often lack the necessary expertise.  Further, if an STD clinician cannot be certain about the diagnosis after direct examination, I would not presume to make a definitive call; just because Dr. Hook and I do an online forum does not make us more expert than any other experienced STD clinic provider.

The estimated time for resolution of warts -- often 6 months and almost always within 1-2 years -- is from the time the HPV infection is acquired, not the time a wart is first noticed.  In any case, I have no way to judge how long you might have had the genital bumps before you noticed them.

Having said all that, warts generally are not associated with hairs.  On that basis alone, my guess is that there is some other cause of your bumps.

Seeing a dermatologist is exactly the right thing to do, and whatever I might say after looking at your lesions would not change that.  I also agree with the STD clinician's advice about holding off on all treatment or manipulation of the lesions for a couple weeks before your dermatology appointment.

Best wishes--  HHH, MD