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Birthmark, Mole, HPV?
Dear Dr. Rockoff,
Thanks for taking the time for answering this question. Yesterday I noticed something that looked exactly like a birthmark, in both color and size, on the head of my penis. The dermatologist diagnosed it as a genital wart, and burned off the growth with a laser.
A couple things struck me that made me question his diagnosis:
1) My only sexual encounter over the past 4 months exactly one week ago. I received oral sex without a condom; I used a condom when we engaged in vaginal sex; there was no condom breakage.The birthmark-like blemish in question was on the head of my penis, and that was unmistakebly covered throughout the vaginal intercourse. It seems odd that a blemish would emerge on the head of my penis.
2) If HPV symptoms show up early, they will normally first appear after 2-3 weeks. Normal time to first symptom seems to be around 3 months. Yet my sexual ecounter happened just one week before daignosis - no later, no earlier. Is the 1 week duration for first symptom appearance consistent with other HPV cases?
3) The growth was exactly the same in color and shape as other birthmarks on my body: nearly black in color, ever so slighty raised (jsut like a birthmark), and the size of a blunt pencil point. Granted HPV strains are numerous and varied, but I searched and searched online for descriptions of similar HPV growths, and could find none that one could mistake for the growth I saw on my penis. The doctor conducted no biopsy. The assumption was that the growth was HPV, then simply straight to laser.
I am left to wonder if the doctor that removed the birthmark-like growth may have just had an itchy laser finger. What do you think about my case? Have you had patients that have birthmark-like growths spontaneously appear on their genitalia in adulthood? Do these cases normally turn out to be HPV or simply birthmarks? Are they easy to diagnose?
Thanks for taking the time for answering this question. Yesterday I noticed something that looked exactly like a birthmark, in both color and size, on the head of my penis. The dermatologist diagnosed it as a genital wart, and burned off the growth with a laser.
A couple things struck me that made me question his diagnosis:
1) My only sexual encounter over the past 4 months exactly one week ago. I received oral sex without a condom; I used a condom when we engaged in vaginal sex; there was no condom breakage.The birthmark-like blemish in question was on the head of my penis, and that was unmistakebly covered throughout the vaginal intercourse. It seems odd that a blemish would emerge on the head of my penis.
2) If HPV symptoms show up early, they will normally first appear after 2-3 weeks. Normal time to first symptom seems to be around 3 months. Yet my sexual ecounter happened just one week before daignosis - no later, no earlier. Is the 1 week duration for first symptom appearance consistent with other HPV cases?
3) The growth was exactly the same in color and shape as other birthmarks on my body: nearly black in color, ever so slighty raised (jsut like a birthmark), and the size of a blunt pencil point. Granted HPV strains are numerous and varied, but I searched and searched online for descriptions of similar HPV growths, and could find none that one could mistake for the growth I saw on my penis. The doctor conducted no biopsy. The assumption was that the growth was HPV, then simply straight to laser.
I am left to wonder if the doctor that removed the birthmark-like growth may have just had an itchy laser finger. What do you think about my case? Have you had patients that have birthmark-like growths spontaneously appear on their genitalia in adulthood? Do these cases normally turn out to be HPV or simply birthmarks? Are they easy to diagnose?
MEDICAL PROFESSIONAL
Of course, you realize that I can't tell you what this spot was because I didn't see it. I'm not sure where you got your information about how long it takes after exposure for a wart to appear, but it's not accurate. Warts can appear years after exposure, so your recent encounter is not very relevant. Having said that, I would add that genital warts are not common on the penile head. I would add that the marks you show me pictures of don't look like warts. I can't imagine that you had a spot that dark on the head of your penis for very long without noticing it, which makes the diagnosis of mole unlikely. In any case, even if it was a wart, it sounds as though it was taken care of, which is pretty much all you can and need to do.
I realize that I haven't given you the certainty you ask before, but that's because I can't. You might want to ask the doctor who took care of you about the certainty of his diagnosis.
Take care.
Dr. Rockoff
I realize that I haven't given you the certainty you ask before, but that's because I can't. You might want to ask the doctor who took care of you about the certainty of his diagnosis.
Take care.
Dr. Rockoff
The marking looked very much like this "nevus" - which is a new term for me: http://www.mmh.org.tw/taitam/derma/Images/nevus.jpg
For you reference, the blemish looked like this birthmark, but darker, a bit less than a square millimeter, and positioned on the glans near the base: http://medimages.healthopedia.com/large/birthmark-pigmented.jpg
The blemish was a single, flatish unit and was not clustered, fleshy and unpigmented like nearly all the pictures of genital warts I've encountered while perusing the Web.
The blemish was a single, flatish unit and was not clustered, fleshy and unpigmented like nearly all the pictures of genital warts I've encountered while perusing the Web.
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