Genital Warts on Hands?

Dr. Rockoff,

Thanks for all the work you do on this forum. My question concerns the possibility that I may have transferred genital warts to my knuckles. I had a genital wart just under 2 years ago, which took about 4 months to resolve with treatment. Before that time, right up to the present, I have noticed some subtle but nonetheless strange changes to the texture of the skin on my knuckles and fingers. In all affected areas, it creates a slightly different pattern on the surface of my skin. In certain places, it produces either a darkening effect or sometimes, seems to produce a thickening of the skin and a keratin buildup. My dermatologist at the time referred to the texture as “pebbly” but didn’t seem to think it was a big deal. One of his assistants was more willing to think they might be wart-related, and described the texture as “cauliflower-like” under magnification.

I know genital warts typically don’t grow on hands, and vice-versa, but how do I know this isn’t perhaps an exception? I’ve had enough cuts and scrapes on my knuckles before and during my infection with genital warts that perhaps the virus moved over onto the skin on my knuckles. What’s strange, of course, is that the wart has completely resolved on my genitals, but would have persisted on my hands for so long: it defines immunologic logic. Also, the skin on my knuckles looks like neither the genital wart (which was a small, hard, white lesion) nor like most pictures of common warts. If I pick at these odd spots however, I sometimes see fairly solid white growths right under the skin. I’ve tried both antibacterial skin ointments and over-the-counter wart treatments on my knuckles to no effect.Everything comes back just as it was. I am curious what you think about my case. If you don't think it's genital warts on my hands, I'm curious what else you think it might be. Getting rid of this, whatever it is, would do a great deal to help me relax and put this whole incident behind me. Thanks.

[Alan Rockoff, MD]

From your description, I doubt there is anything wrong with you at all, and that you are looking at your knuckles too hard.  If you could spread genital warts by touching, everyone with genital warts would be covered with warts from washing, etc., but they're not.  Even if what you have on the hands are warts--which I doubt--they would be non-genital warts.  I think your anxiety is misplaced, and that you should confirm with your dermatologist that you don't have warts on your hand and that you should then forget about contaminating yourself and move on.

Take care.

Dr. Rockoff

[Watintheworld]

I'd just like to comment, that I'm in the same exact situation. The description from the thread starter is spot on (thickening of the skin and a keratin buildup).

With all due respect, Dr. Rockoff, can't this be a possibility? Can pathologist type a specific hand wart to see if it's genitally related?

Just looking for the answers. Thanks.