Question about unclear genital wart diagnosis

[Watintheworld]

Hi there Dr. Rockoff. I've debated for a long time about posting on this forum, but decided to do so anyway. In late August of 2008, I had protected sex with a female co-worker. (First sexual experience). Immediately after (as in the next couple days), I noticed a rash like area on my side outer thigh proximal to my lower butt. When I got water on it, it kind of stung like when an open sore is exposed normally to water. I went to the health center at my school and got some bacetracin to put on it, which mainly cleared it up and shrunk down but even now there is still a faint darker coloration (really hard to see). I then started to experience almost a throbbing pain at the tip of my penis so decided to go get a full panel STD test. Everything came back negative.

I went to a couple doctors at my school because I noticed when I would get out of the shower some parts of the tip of my penis would be white almost (splotchy).. I got tested from everything to HSV1/2 to HIV. I even went to the city clinic and got a visual examination of the areas and some suspecting small bumps.

It started to hurt in the perenieal area so I went back to my school's health clinic and had a prostate exam (of all things...). Still nothing. I saw a newer doctor at my school and he examined my penis and didn't see anything out of the ordinary. I ended up going back to the other doctor I had been seeing and mentioned about some bumps on the tip (that I hadn't noticed before, but to me, they don't look normal [maybe they HAVE been there, but I've been so shaken up about this whole ordeal that I may have overlooked that]).

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[Watintheworld]

Hi Dr. Rockoff.. I'm still debating whether or not to see another doctor to see if he can prescribe me some Aldara or something to use more than the sample packet I tried. I really do think that these are warts. I have some updated pictures if they help... the last ones didn't do any justice.


http://img3.imageshack.us/my.php?image=bumpsnj8.jpg
http://img110.imageshack.us/my.php?image=bumps2ny1.jpg
http://img3.imageshack.us/my.php?image=bumps3mc7.jpg
http://img3.imageshack.us/my.php?image=bumps4jc3.jpg

What do you think?

[Watintheworld]

Thanks a ton Dr. Rockoff. It's reassuring having someone like you look at my issue (even if it's over some pictures on the internet). I really appreciate your time and help that you've invested into this website. I also think you are right about the counseling issue. :)

[Alan Rockoff, MD]

These do not look like warts.  They look like the bumpiness one typically finds on or near the head of the penis.  You are staring at this area out of anxiety and concern and noticing things that most likely have always been there.  I do not recommend a biopsy.  I do recommend that you stick with the dermatologist at school, and that you look into ways (such as counseling) that may help you get over your worries about sex.  You're spending, I think, far too much time thinking about and photographing your genitals.  Time to move on.

Best.

Dr. Rockoff

[Watintheworld]

The doctor that I had been seeing at my school is an older (retired but works on occasion) doctor but he is a clinical dermatologist and said he used to run a wart clinic back in the '80s. He examined my penis up through a specialized magnifying glass around the rim for about 30-40 seconds and didn't note anything out of the ordinary. It was red and irritated because I had been picking at it, so he prescribed me some steroidal hydrocortizone.

I ended up going out of town to get some cosmetic things done at a cosmetic dermatologist (newer guy) who took a skin tag I've always had off under my armpit and froze a wart on my finger I've always had. I told him everything I've told you, and he checked it under an incandescent light for about 10 seconds and said that I have a few warts on the tip.

I went back to the clinical derm. @ my school and he said that the derm. was incorrect with his diagnosis. I have been contemplating getting a biopsy done.. but I'm just not sure what the heck to do. Also, I've noticed on the skin where I was circumsized, there is a spot that is a bit darker and feels bumpy but when I stretch the skin, you can barely see anything... not sure if this is related. I've also now noticed a very small red dot under the rim of the tip of my penis. I've enclosed some pictures (couldn't get a pic of the red bump...) I just don't know what exactly to do. Go back to the city clinic and see a different doctor? Get a biopsy done? Even if I got a biopsy done and it came back unclear does that mean warts aren't ruled out? I've been reading day and night about HPV so I'm pretty well educated on this subject -- I just need to know if you think I have it or not for sure. I decided to post in your forum instead of Dr. HHH's because I heard you check some pictures. Hopefully you see these. Thanks

http://img12.imageshack.us/my.php?image=cimg0698wn4.jpg
http://img60.imageshack.us/my.php?image=cimg0703fg2.jpg
http://img12.imageshack.us/my.php?image=cimg0728kc1.jpg