Great confusion

[tildon4]

Hello. I'm an American studying abroad in the UK. Back in March, I noticed four small bumps on the shaft of my penis. They were irregularly shaped and slightly hard to the touch, and they were larger when the skin was taught than when it was not. The dermatologist I saw here diagnosed them, after a bit of hesitation, as warts (and gave as his prime justification for the diagnosis the fact that multiple spots had appeared close together). He told me that a biopsy was unneccessary. He then froze them off with liquid nitrogen. His diagnosis was obviously disconcerting, but I accepted it. Then I went back home to Florida over my spring break, and another bump appeared on the shaft. It seemed similar to the ones I had had frozen off, but it's impossible for me to tell if it's identical. I went to another dermatologist very promptly. He said that he did not believe the spot to be HPV. . .that it was most likely a "fordyce" spot and/or inflamed sebaceous gland. I did not request a biopsy of this new spot because I realized that, even if it were negative, it would by no means prove that the previous bumps were NOT HPV. So here are my questions (which I should have asked my American dermatologist, but forgot to in the haze of it all): 1) Is it indeed possible that the spots my English dermatologist froze off were fordyce spots or sebaceous glands instead of HPV? Can such spots even be successfully frozen off? (Though I can see now, in the area where those bumps were frozen, what look like tiny bumps left over.) 2) Should I expect this present fordyce spot/sebaceous gland to disappear of its own accord or not? I was not born with this thing and I was naturally monitoring myself carefully. . .it just appeared. 3) For my clarification, is a sebaceous gland or fordyce spot considered a "cyst"? Because I have read that they cannot be removed by freezing. Sorry for the long message. Thanks.

[Alan Rockoff, MD]

Bumps along the shaft could very well be warts, and the fact that you got another one is consistent with warts as well.  On the other hand, these could indeed just be cysts.  Freezing can make cysts smaller.  so, although it may not be possible to reconstruct what you had in England with certainty, I suggest that you ask your dermatologist over here whether a biopsy could be considered, just to reassure you.  On the other hand, if he is quite sure on clinical grounds that it isn't a wart, and if the current bump looks just like the English ones, I'd just forget about it.  If you get new or different-looking ones, you can look into it then.

Take care.

Dr. Rockoff