Not sure where to go from here

Two years ago I had unprotected sex.  Within a short period of time, 2 weeks or so, I noticed a pin-head sized, flat, "freckle" on the head of my penis.  I have never had anything similar there in the past.  After being told it was nothing, I eventually had it biopsied where I was told there was no indication of wart infection, and it was diagnosed as a benign lentigo.  Since then several more spots of varying sizes have appeared, always on the head.  They are darker than surrounding skin, but still can be difficult to see unless under the right light.  There has never been any pain or itching of the area.  I had a second biopsy taken and was told there was again no indication of warts, and also that there was no sign of post inflammatory symptoms.  Both biopsy slides were reviewed by a second doctor, who did not see anything to be worried about.  He believes it to be penile melanosis, or genital lentigiosis.  My questions are:

1)It seems most warts are raised, but can be flat, have you ever biopsied something similar, and come up with genital warts?

2)Knowing anyone could eventually have genital warts with no visible sign, are biopsy results considered conclusive for these particular areas?  Would it matter that the biopsies were not completed until quite some time after first appearance?

3)Due to when I first noticed this, I have trouble believing this appearance is not something that was transmitted sexually.  Is there any other STD I should be worried about, or tested for?  Would I know if this were a Hepatitis or Herpes infection?  If these spots were another type of STD, would something show up in the biopsy?

Thanks

[Alan Rockoff, MD]

1. No.
2. Yes--you're describing a lentigo, or freckle, and that's what the biopsies confirmed.  The timing of the biopsies is unimportant.
3. I understand your concern, but believe it is misplaced--just because something happened after something else doesn't mean the first caused the second.  It could just as well be that because you were worried about the first, you looked harder and found the second.  That certainly seems more than likely in your situation.

You've done more than your share of due diligence (biopsies.)  Time to take yes for an answer and move on.  If you can't, consider counseling so you can get your life off hold.

Take care.

Dr. Rockoff