HPV genital wart ?

[Fouwithau33]

Doctor,
8 weeks ago I had vaginal intercourse.  Since then I have had a red scrotum.  It has not responded to medication for yeast/fungal infections.  I also have a small rash on my inner thights in the last 3 weeks.  As you can imagine I have tried creams, tea tree oil, powder etc to clear this rash.  After 6 weeks I noticed a sliver of skin on my left testes near the base and side.  It initiially looked like a flake of skin but when I examined it I realised it was attached.  It appeared to be a growth.  It lookded for all the world like a flake of skin but I tried to remove it and it bled.  The next day i visited my GP who on close inspection told me he believed it was a single wart.  He froze it and it was gone after 3-5 days.  It went white after freezing.  It was I suppose 5mm long and very thin.  I have had no recurrences since.
My questions are 1) Do you think this was a wart from description?  
If not, what might it have been?
If I wish to form a relationship with a girl will I be in danger of pasing on the virus without any symptoms.

Finally, any suggestions about the red rash.  Am at my wits end.  

Kind regards

[H. Hunter Handsfield, M.D.]

Maybe a skin tag, which is a normal anatomic variant that you might have just not noticed before the rash drew your attention to the area.  But that's only a guess.

[Fouwithau33]

Thank you Doctor for your detailed reply.  Much appreciated.  Might I quickly ask what else this piece of skin/growth might have been if it wasn't a wart. Any possibilities come to mind.
Meantime I will take your advice on the creams/ointments and keep it to soap and water until I arrange an appointment
many thanks

[H. Hunter Handsfield, M.D.]

Nothing you describe sounds much like a wart.  However, the opinion of a provider after direct examination has to be respected, especially if s/he has substantial experience with gential warts.  On the other hand, it is uncommon for genital warts to present with a single lesion; usually there are at least a few; and since you had traumatized the lesion, perhaps its appearance was altered and might have made diagnosis by visual inspection more difficult.  Although genital warts are fairly common on the scrotum, most cases in men involve the penis.  That the lesion turned white with freezing means nothing; all tissues turn white when frozen.

In summary, I don't know whether you had a genital wart or not.  Certainly the redness and irritation of the scrotum and inner thighs has nothing to do with warts or HPV.  There are numerous potential causes for such symptoms, none of them sexually transmitted.  Tinea cruris (jock itch) and a bacterial infection called erythrasma sound like possibilities.  Also, whatever started the problem might now be dominated by something else, such as irritation from the attempted treatments.  Certainly tea tree oil can be very irritating.

In summary, I believe you have had 2 separate problems, the genital bump that may or may not have been a wart; plus the genital area skin irritation.  I suggest you see a dermatologist.  Until then, stop any kind of creams or other treatment.  Just wash with soap and water once a day and keep the area dry, nothing else.  My bet is that the dermatologist will make an immediate diagnosis on quick inspection, at least of the skin irritation if not the possible wart problem.

In the meantime, this isn't worth a lot of worry.  When all is said and done, the rash and wart problem almost certainly are minor inconveniences, not serious health problems.

I hope this helps.  Best wishes--  HHH, MD