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STDs  (Expert Forum)
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Follow up to Genital Wart or Regular Wart Posting....
Answered by
University of Washington Seattle - WA
Welcome to the STD Forum, which is intended only for questions and support pertaining to sexually transmitted diseases other than HIV/AIDS, including chlamydia, gonorrhea, syphilis, human papillomavirus, genital warts, trichomonas, other vaginal infections, nongonoccal urethritis (NGU), cervicitis, molluscum contagiosum, chancroid, and pelvic inflammatory disease (PID). All questions will be answered by H. Hunter Handsfield, M.D. or Edward W Hook, MD.

Follow up to Genital Wart or Regular Wart Posting....

by MakaveliMOB, Oct 19, 2005 12:00AM
Dear Dr..

I am very confused and have great anxiety regarding skin lesions now. I left you a post, titled "Genital Wart or Regular Wart?"  You might want to read that to know where my head is. Anyway, I had that lesion biopsied from who dermatologists call the Expert Dermatopathologist here. He diagnosed it as a Seborrheic Keratosis. My dermatologist said that it was a Benign Keratosis. I asked him how I could of  got it, and he said it was a genetic thing and I was just programmed to have it.  

1 week later I started snooping around that area again and started looking very closely and i saw something very small close to where that other lesion was. It was little bump emerging from dry-like skin. I could stretch it out, and the bump out stretch out too, almost completely flat. But when the skin would scrunch up, it would show a tiny bump. The derm said that it was probably a skin tag, or a keratosis, he burned it.
1 week later than that, i started snooping again, stretching the skin in the groin, genitals, looking around. And a day or so after I noticed that i developed Folliculitis on the left groin area. I saw inflamed follicles with hair coming out of them, if the hair was not in them, i would probably thought they were warts, they were that inflammed, from the stretching of skin, etc.  Topical cream was prescribed.

This week, i started snooping again, checking the area that had Folliculitis, and I saw something that was not there before. It was a small thin layer of skin that looked like it was on top of the regular skin. It was very small. And it looks the same as a sheet of paper on a table, that type of thinness if not thinner. It is white/skin colored. When the skin is stretched, to the point its going to tear, you can see little squares, kind of like an arial view of a city and streets...and this looks like one of those blocks, imflammed a little inflammed. if the skin is scrunched up, it disappears, and if lightly stretched in a direction, the skin lines will move in that same direction. It does not look like anything solid on the skin. Derm said it could be normal skin that when scrunched up maybe look weird, beginnings of a tag, or keratosis. No worries about warts.
Am I causing all these myself. I know that the first Keratosis was an area, i put a lot of pressure and contact, rubbing on, and I know Keratosis is a thickening of the skin, i am wondering if i could have caused that myself. And the thing i found now, is also in an area in which i rubbed a lot and stretched the skin a lot.

I mean this is like the 5 th biopsy ive had in that area, every little thing suspicious, ive had him take off and biopsy, regardless of his opinion. And mostly he has been right,  i had a  Tag, I had a Benign Acanthosis (bump on scrotum), I had a S. Keratosis on thigh.

Then I read that Keratosis on thigh or genitals are actually genital warts. But there was no virus found in the sample.

Pls Help.
Thanks in advance for your insight

by H. Hunter Handsfield, M.D., Oct 19, 2005 12:00AM
I'm sorry, I have no comment or suggestion. I am not a dermatologist, but to my knowledge the biopsy results are definitive.  If there is no biopsy evidence of HPV, you probably don't have HPV.  All I can do is encourage you to trust your dermatologists' diagnosis and advice and trust their judgment.

Good luck--  HHH, MD
Member Comments (7)

by MakaveliMOB, Oct 19, 2005 12:00AM
To: Doctor
The post I left was on  9/5/05  "Genital Wart of Regular Wart"

Thanks.

by MakaveliMOB, Oct 19, 2005 12:00AM
To: Doctor
Correction: I just read the biopsy of what was on my inner thigh...It said that it was a Benign Keratosis. No cytologic atypia.

In the Differential Diagnosis, it said that it could be an early Seborrheic Keratosis.

Is this worth getting an Immunophenotype test ? Or should i just assume it was benign thickening of the skin by irritation, because if there were anything suspicious within the cells (atypia) or the tissue (similar to condyloma) then it would have been stated?

Thanks.

by MakaveliMOB, Oct 19, 2005 12:00AM
To: doctor
Why cant I see your response?

by MakaveliMOB, Oct 19, 2005 12:00AM
nevermind. thanks for the response. i just wanted to post the results to you anyway.

i think your right. ill trust their judgement.


thanks.

by MakaveliMOB, Oct 20, 2005 12:00AM
To: TO THE DOCTOR.... ONE LAST QUESTION PLEASE........
hi Dr.


Just wanted  to know how accurate Biopsy's are???  How often are VLP's not seen in tissue or Dysplasia not seen in tissue where HPV is present? Are these factors missing in Smaller lesions?


Thanks

by H. Hunter Handsfield, M.D., Oct 20, 2005 12:00AM
To: confused662
My response above says "to my knowledge the biopsy results are definitive" in diagnosing warts; so you don't have warts.  How can I be more clear?

Yes, of course you could have latent HPV persisting in tissues not sampled in the biopsy.  Many people, probably most of us, do.  There is no test, biopsy or other, that can rule that out.  It doesn't matter in terms of health risks.

HHH, MD
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