Looking for a real expert analysis.

[345medhelpFAN]

Jan/Feb 2004 I was exposed to a girl with visible genital warts.  I watched myself carefully and did not notice anything.  In May 2004 I did notice two very small bumps at the base of my penis (Top of the penis, just in the hairline where the penis is attached).  They appeared to me as shave bumps and I picked at them hard, and they appeared to go away.  In June 2004 I was checked out by a urologist, he used vinegar and magnification and said I was cleared.  Some point over the summer those two bumps seemed to show up again, again I felt it was from shaving.  I then decided to get checked out by a dermatologist to make sure I was in the clear.  This was only recently on 3/22/05.  He said they were warts.  He also treated two-three other small spots at the base of my penis on the opposite side.  He froze them, since then I believe I have maybe two other small ones in the same area, not that they are new, but given what he treated, they seem to fit the mold.  They are very small, firm to the touch, up in the hairline on the top of the penis.  I was going to go back to have him freeze them but I have some concerns.

1.  2 of the 5 seemed to have a small hair in them, not coming thru the middle, but some part of the bump had hair in it.
2.  They are small, at the very bottom of the shaft, not out in the open where you can easily seem them.
3.  Given my initial exposure to warts, and when I first noticed something, its been almost a year.
4.  I guess the urologist gave me the all clear because the bumps were gone briefly during the time he saw me, but that does mean he missed the other bumps on the opposite side.

These reasons raise some doubt in my mind.  I am thinking of going to a different dermatologist and not saying anything about warts and see what he says.

My questions:

1) If they are not warts, what else could they be?
2) I have not shaved the area in months, but does that matter?
3) Overall, what would you advise.

Thank you!

[Alan Rockoff, MD]

If they have hairs in them, they might be inflamed follicles.  These can come from shaving, but not necessarily.

I advise you to have someone look and perhaps take a biopsy.  I do not as a rule recommend a biopsy for warts, but in your case I am not at all sure that's what they are, and rather than have them treated as warts, which will leave you in fear that they might have been, a biopsy will tell you for sure one way or another.  A biopsy involves a small shot of anesthesia, and removal of a very tiny piece of tissue.  At any rate, I think it merits consideration.  As a dermatologist.

Best.

Dr. Rockoff

[345medhelpFAN]

Thank you...I have an appt with a new derm this Thursday.  I was also looking at the forum and I wasn't sure of your opinion on prospective partners...meaning, once I have been treated and warts are gone, do I tell a new girl I may like about the warts.  If I met her today and next week we were about to get intimate then I would let her know I have just been treated, but what about two months from now if there is no new warts?  All literature I read says HPV that leads to warts is harmless, and warts themselves are harmless and go away eventually.  This is not HIV or herpes...what is the general rule on this?  thanks.

[Alan Rockoff, MD]

Even if you're sure you have warts, all you can do is make them go away.  In your case, the best way I can think of to be as sure as anyone can be that they weren't warts is to have a biopsy.  If you end up being unsure, I would tell partners that you were once treated but that they probably weren't warts, which is I think both fair and accurate.  People need to live with some degree of uncertainty....

Dr. Rockoff

[345medhelpFAN]

Got results of biospy.  Warts.  So I don't have anything on me right now.  I have a personal question.  I just started dating someone that I really like...how should I go about sharing this info?  Is there a line that you think works well and puts someone at ease?  Like, "what I am about to tell you is harmless, but in wanting to be honest, I feel I should share?"

[Alan Rockoff, MD]

All you can say it that you once had warts, they are treated, and they are gone.  

Dr. Rockoff