Skin tags vs. warts

Hi, last August I went to a public health clinic to get STD tests. I asked the nurse to look at two fleshy growths around the head of my penis that had been there for several years and was told they were genetial warts. I was devastaed but then she said the only way to know for sure was to have a dermatologist look at them. Luckily I had a dermatologist appointment a week later. A little background on me is that I get skin tags almost EVERYWHERE on my body and am currently battling a weight problem (I've read obesity can cause the growth of skin tags. Also 11 years ago I had some excess skin removed from my penis (It wasn't a full circumcision). There was a scar that left and not all of the skin removed (I read this could cause them as well). The growths are almost exactly where the incision are and have been there for several years. Anyways a week later a went to the dermatologist and he looked at both under microscope. He said he was 99% sure they WEREN'T warts but indeed skin tags and said the 100% sure was to biopsy it. But he said w/my history of tags and the fact they weren't around the shaft then he was positive they were tags. He advised me not to remove them because of the area they were in and the discomfort they caused. My question are tags often misdiagnosed as warts? And do warts moble and move around like these tags can? It was a traumatizing experience for me and I'm still a little angry and confused about it. Should I go ahead and leave to tags alone or get another opinion? They don't hurt and have been there for several years and aren't visible unless I stretch the excess skin on my penis. I'm also afraid that she marked that I had warts in my file since this is a public health clinic. My dermatologist was pretty reassuring but still the 1% question still lingers in my mind.

[Alan Rockoff, MD]

Certainty in medicine, as elsewhere, is hard to get.  Still, I think that opinion by your dermatologist who looked carefully sounds quite reasonable in view of your history and what you describe the doctor found.  I don't think a biopsy is needed.  As to the record at the STD clinic, it probably won't cause problems for you in the future, but it wouldn't be out of order for you to write them and enclose a copy of your dermatologist's opinion, requesting that they insert it in the record and note its implications with a note of their own.

Take care.

Dr. Rockoff