Bump on penis

[jeep04]

Question1:
I noticed about 6 days ago one bump at the base of my penis, pretty much right in the pubic hair.  It is not round, more oval, reddish, raised and soft to the touch.  A few mm in size I would say.    I was told that I have pearly penile papules years ago. This does look different than those.  Though it is in the exact same region. Furthermore, it does not quite look like any ingrown hair that I ever had as it does not look like a pimple.  I am worried because it is still there.

Question 2:
I have 2 bumps close together that I thought were papules that are larger than my other other ones. They look like all the other ones, flesh colored just slightly larger.  I noticed it months ago and they have remained the same size.  May have been there for a while I just never noticed.   Is this normal or am I being paranoid?  Should I get them looked at?

I have been in a committed and monogamous relationship for the past 15 months.   I am concerned that this may be something that I could give to my girlfriend.  I realize that you cannot diagnose me over the internet or look at pictures.  Is this something that I should go to the doctor and get checked?  If so what kind of doctor?  Thank you so very much for your time.

[Edward W Hook, MD]

In most patients molluscum is a nuisance which is easily treated by your dermatologist using topical therapy.  As an FYI, it is also transmitted by contact so it is not solely an STD, if that is important. Other than the cosmetic issues, there are no long term consequences.  Similarly, if your GF should get it, there is no risk to her. EWH

[jeep04]

Thank you for the reply.  I got a call a few weeks ago and I wanted to let you know the results.  The excision came back as a molluscum.  The nurse practitioner at the Dermatologist was surprised as he was almost positive that it was a genital wart.  I am glad that I decided to get the biopsy. He said that it is a virus and can be spread by contact like sex.   I have some bumps that are located right at the top of my pubic hair line and he said were molluscum. Is there anything that my girlfriend and I should be concerned about?   Thank you so very much in advance!

[Edward W Hook, MD]

Sounds to me like you are asking the right questions and from your last paragraph, approaching this is a mature way.  My congratulations to you.

You and your GF both have HPV, most probably two different types. The type of HPV that causes visible genital warts rarely causes abnormal pap smears and vis versa.  I would also point out that while you both have exposed each other, there is no reason to necessarily believe that one or the other of your brought HPV into the relationship - either or both of you may well have had HPV long before you started dating.  Turns out that well over 80% of people (and I think those numbers are probably conservative) will have HPV at some time in their lives. In most cases they are not a big deal - they cause self limited infections which go away on their own.  Even your GF's abnormal Pap might become normal over time although many GYNs would treat sooner than later (not an unreasonable approach either).  I see no reason for you to change your sexual practices with her because of these findings since you have each been exposed to each other’s virus.   I do however agree with the PA that you need to be careful about contaminating your open biopsy site during sex.  Take a few days off.

Hope this helps.  EWH

p.s.  Please let us know whqat the excisional biopsy shows. The location of your bump was an unusual place for a wart.

[jeep04]

Dr,

     I posted earlier (8 OCT) with a question. Thank you for you prompt reply.  Well my neurosis got the better of me and I decided to go and get the reddish bump at the base of my penis checked by a dermatologist today.   The nurse practitioner saw me and said that he was pretty sure that it was a genital wart.  He gave me a few options, freeze it, some type of creme, or cut it out.  I chose to have it cut it out and to have the biopsy performed.   I want to know for sure what it is for my own piece of mind. Now I am awaiting the results.  Staying positive.

    I have been with my girlfriend for almost 16 months and we are monogamous.  She recently had an abnormal PAP(last July) and was told that she has HPV(high risk kind).    I am pretty sure that if she has high risk HPV then I do as well. We both got tested last April for STDs with negative results. Therefore, we have stopped using condoms. I have not had intercourse with her for the past 5 weeks(we live on different coasts).  We are seeing each other very soon.  

    When would it be okay to have sex?  The nurse practitioner seemed more concerned with the open wound being clean and possible infection.  He said to see how I feel in a few days.  Do I go back to using condoms(the condom may not cover the wound and may irritate it?  Plus as we know the condom does not cover everything.  

    Do we both have the low risk strain of HPV already?  Will we be both be infecting one another?   I want to be responsible and not spread this to her if I am still contagious.  That is why I decided to get it cut out today an biopsied.  Is there anything that my girlfriend should do?  Thank you for your time.

jeep04

P.S.  To all you out there that are freaking out, I feel for you.  This is really not that big of a deal there are way way worse things to have.  This does not make you dirty or unworthy of love.  It makes you human. Albeit a more informed one.  

[jeep04]

Thank you for your reply.  In regards to question 2, the bumps are at the base of my penis.  There are many small bumps in that general region at the base of my penis and on my scrotum.  They have been there ever since I can remember.  Just those 2 seems larger as of late(last few months) I just thought that this was the way that I was made.  Thanks again I will get in contact with a dermatologist.

[Edward W Hook, MD]

Thanks for the description and questions.  I agree with you that the lesions you describe are not likely to be something to worry about.  As to what they are, as you point out, the right person to speak with is probably a dermatologist.  Several comments:

1.  Pearly penile papules typical are at the head of the penis, near the glans, not at the base.  What you describe could be an atypical folliculitis lesion. Other possibilities include a "skin tag" which is just what the name says and is benign, or a subcutaneous cyst,(which would also be benign)  The location and description really do not sound much like a wart or molluscum.  A dermatologist should be able to help you sort this out.

2.  You do not say where these bumps are.  Irrespective however, the duration just about guarantees that they are nothing serious.  I wonder again about cutaneous cysts.

The dermatologist should be able to help you with each of these.  I do not think they are urgent issues and are most likely not STDs.  Hope this helps.  EWH