Confusion regarding HPV presenting as skin tags

[BB2109]

Hello doctors, first I just wanted to say that this forum is great and I appreciate in advance any help you are able to offer me.

I am 27 year old female who has been in a monogamous relationship for the past two years.  I have twice in the past five years been diagnosed with high-risk HPV, had cervical biopsies of tissue, never showed signs of gential warts, and have had a negative pap and HPV test within the last 4 months.

My question involves an abnormality in the skin I found around the opening of my vagina yesterday.    The piece of skin is smooth, brownish, or flesh colored for the area in which it is located, and can be pulled away from my skin or stretched. I have had warts on my hands and feet as a child, and this looks and feels nothing like those.  I also have skin tags in the normal places on my body, my armpits, underneath my breasts, and one in the groin area that has been there for years. Although they are darker in color, they feel similar to what I feel at the opening to my vagina.  I am concerned because I have read in various places that genital warts can present themselves as skin tags, and I want to know how often this actually occurs.

I am not currently in the United States and will not be able to see a doctor there for at least two weeks.  I am planning to see my doctor as soon as I return, I just would like some insight into the situation before two weeks has passed.

My question has three parts:

1) Could this be a genital wart or is it more likely a skin tag?
2) I had various unprotected encounters before my present relationship with no signs of genital warts, but have been with the same partner for the past two years and have never presented signs of genital warts.  Is it common for it to take years for a wart to appear?
3) Do I need to stop having sexual intercourse with my partner?  

[Edward W Hook, MD]

I woldn't worry.  Your health care provider is erring on the side of caution.  She has your best interests in mind and that is hard to argue with.  My guess is that this will prove to be a skin tag.  EWH

[BB2109]

I am unsure whether I am able to ask follow-up questions here, but I figured I'd give it a shot.

Upon returning to the United States, I saw my doctor (she is actually a P.A.) about the lesion mentioned above.  She told me that at first glance, it appeared to be merely a skin tag, but upon further inspection with a magnifying glass, she was unsure.  She suggested I have the lesion surgically removed so that it may be biopsied.  I am going next week to have the procedure.

My question involves the likelihood of a single genital wart appearing on a person two years after infection.  Is this very likely to happen or not?

Also, I have read that rarely are genital warts biopsied unless they are persistent or have an unusual appearance.  My doctor also inspected the rest of the area and said she saw no other growths.  I guess I am just confused as to why a biopsy is needed for a correct diagnosis.

Thank you for your help.

[BB2109]

Thank you for answering my questions, Dr. Hook.  Your answers have been very helpful, as I was having a very difficult time finding accurate information about this issue elsewhere.  Once again, your time and expertise are much appreciated!

[Edward W Hook, MD]

Straight to your concise and well phrased questions.

1.  What you describe sounds far more like a skin tag than a genital wart.  Some persons get more of these than others and if you have gotten them in other places, this may well be one as well (furthermore, as persons get older, they tend to get more skin tags).  Either way, this is not emergent or something to worry about.  It can wait till you get back to your regular doctor.

2.  Typically, when warts are transmitted, they appear within a few weeks or months of contact, not years later.

3.  No, I see no reason to do so.  If these are warts, he has been exposed.  If they are not, no concern there either

Hope this helps.  EWH