History of HPV warts, possible reoccurrence, but no response to treatment

I was diagnosed with vaginal HPV warts a year and half ago by a gynecologist. I was successfully treated with Imiquimod cream for 3 weeks and confirmed that all visible warts had cleared. 6 months later I noticed 2 bumps in the perianal region (not where my original outbreak occurred and very unlike the vaginal warts) and sought treatment at Planned Parenthood where the practitioner removed them with TCA thinking that they could be HPV warts. 2 months ago, I noticed a very tiny bump near my anus and went in to Planned Parenthood again to have that looked at. The practitioner said that it didn't look like HPV but there was no way to be sure. I asked if I could have it biopsied and she said that it was too small. She said she could treat it with TCA, but I opted not to do TCA treatment as I was about to work as backpacking guide for the summer and I would not have the proper hygiene environment for a TCA wound to heal. She instead prescribed Imiquimod and I have been using it as directed for the last 8 weeks and I have seen no change in the bump. The tissue around the bump has become inflamed and red, and clearly looks like the area is having an inflammatory response. I'm wondering if I am right to think this new bump is not HPV as it is not responding positively to treatment as my previous warts have. I want to know when I can "set the clock" in terms of being free of warts as I have been abstaining for sex for the last 18 months and I would like to eventually be able to have a sexual relationship with a low risk of transmission.

[Griever3000]

ok let me get this down straight. So it has been a total of 1.5 years since your diagnosis correct?

After initial treatment, you had no recurrances besides the one suspected at 6 months in the perianal region, which was treated with TCA.

then after about 7-8 months or more, you noticed some lesions on the anal region?

I would see a dermatologist for the best diagnosis. Planned parenthood really isnt all that great.

in my opinion, i think that your body has taken care of the warts and youre good. Just follow up with a derma. get your lesions checked and get a piece of mind. Good luck

[j6101]

Does anyone know what the cost for a derm biopsy would be (insured vs. uninsured?)