severe genital warts outbreak

[makingmyselfnervous]

Hello,

Two years ago I was diagnosed w/ genital warts (just one, actually) and had it treated by cryotherapy. That summer more warts broke out, and I took Aldara under the guidance of my physician. that seemed to clear up most of them. I had some smaller outbreaks in the coming years, usually corresponding to stress. I had some extra aldara and used it, normally it worked OK, but it still left small warts occasionally.

This year I had an outbreak while studying for the exams and took aldara to clear it. 8 days ago I woke up to find a rash in my groin, on the underside of my penis and top of the scrotum. I figured this was just irritation from sweating a lot in the heat, so I applied zinc oxide/mentholated powder (gold bond) and let it rest. It didn't go away, so I tried cortisone 1%, which relieved it. Then I observed what appeared to be a huge outbreak of pink warts (>10) on my penis and scrotum (some at the tip, so they're not follicles). Can cortisone cause outbreaks? It is a type of immunosupressant, right?

I found out my physician moved away recently, so I was treated by a female ARNP who wasn't too eager to look at my genitals and so these have never been observed by someone other than myself.

I decided to try podifilox .5% solun. instead of aldara. Now I've noticed what appear to be flat, moist pinkish red growths ~3 mm  in my crural region, bilaterally, and they appear to be "kissing." They don't feel painful, though they do itch, so I believe that they are warts. At first i thought it was tinea cruris, which i've had before, and so I applied lamisil. They only seemed to spread, so I fear they might be herpes lesions, but from what I understand herpes presents a blister, breaks, and leaves a sore (I have had HSV1 on the lips in the distant past). I never noticed any blisters, and I did notice some warts on the scrotum in areas that appear to touch the crural region when i'm sitting, so i believe that I might have autoinoculated myself there (not to mention by scratching a bit). I have had the crural lesions since friday. Should I try to apply podifilox to these lesions? I'm really frustrated as it seems to spread and I'm not sure if it's just HPV. Does atypical herpes sometimes look like pink nonulcerated lesions? Are new warts usually reddish pink? most of my new ones are reddish, the old ones are gray. Can I use aldara and podifilox at the same time in different regions? They have different mechanisms, right?

Also, my scrotum is still irritated, it has been for about 1 week (sans cortisone).

Could these by condyloma lata from 2ndary syphilis?

These bastards have ruined my summers for the past 2 years.  Ugh!

Thank you for your attention.

[makingmyselfnervous]

That made me laugh.

You are probably right, I applied podofilox to the crural lesions and it burnt like the dickens. I was kind of worried that it was herpes! Ha.

What moisturizers do you recommend?

Thanks.

[Alan Rockoff, MD]

Sir:

You have gone off into the wild blue yonder.  Please come back!

1.  Stop applying podofilox to what may not be warts at all.
2.  Use nothing on your genital skin other than bland moisturizers.
3.  Please see a doctor who is not afraid to examine your genitals and who knows what warts and STD's look like.

From your description, I have doubts that you have anything more than irritation.  Please leave yourself alone and find out.

Thanks.

Dr. Rockoff

[makingmyselfnervous]

I forgot to mention that I am a 24 yo white male.

[makingmyselfnervous]

The crural lesions are a bit sensitive now. Is there any way to relieve the diffuse red rash on the underside of my penis and top of my scrotum without encouraging the warts?