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genital wart misdiagnosis
I last had sex approximately 25 months ago (11/07). I am 31 and have had 3 sexual partners. I had been with my last partner for 1 year. None of my partners have advised me that they have or have had gential warts. Approximately four or five months after my last sexual encounter (it may have been more; frankly, I just cannot remember with specificity), i developed what I thought were three moles near my pubic region. Specifically, they were located at the top of where my pubic hair grows under my belly button and the other one was located in the crevice between my leg and pubic area. The moles were dark brown and black. One mole was flat and appeared to simply be a circular skin discoloration. the moles did not or otherwise cause discomfort. I had an exam last week with a dermatologist, who examined the moles and said that theywere genital warts. she couldn't quite tell what the "flat" wart was, so she sent it for biopsy. she then 'froze' the three warts.
(1) I have reviewed the information on this site as well as other webistes and have yet to see a picture of genital warts that looks like what I had. I realize there is no hard and fast rule relative to what the warts looks like, but the 'warts' that were removed from my pubic region looked like the other moles on my body. They were dark brown and/or black, same size, etc. In light of the above fact scenario, was there a chance of misdiagnosis? Should I follow-up with my doctor or speak to someone else?
(2) I had a biopsy performed only on the "flat" wart. Will that tell me if I am in fact suffering from genital warts? If it returns negative, does that mean that my doctor's initial diagnosis was incorrect? no biopsy was peformed on the other two. is it too late to have one done?
(3) I've read posts that I will not be contagious after 6 months. what is the triggering date? when the mole was 'frozen' or when I can no longer see the scab? If some other date, then which date is the triggering date?
(1) I have reviewed the information on this site as well as other webistes and have yet to see a picture of genital warts that looks like what I had. I realize there is no hard and fast rule relative to what the warts looks like, but the 'warts' that were removed from my pubic region looked like the other moles on my body. They were dark brown and/or black, same size, etc. In light of the above fact scenario, was there a chance of misdiagnosis? Should I follow-up with my doctor or speak to someone else?
(2) I had a biopsy performed only on the "flat" wart. Will that tell me if I am in fact suffering from genital warts? If it returns negative, does that mean that my doctor's initial diagnosis was incorrect? no biopsy was peformed on the other two. is it too late to have one done?
(3) I've read posts that I will not be contagious after 6 months. what is the triggering date? when the mole was 'frozen' or when I can no longer see the scab? If some other date, then which date is the triggering date?
MEDICAL PROFESSIONAL
Welcome to the STD forum. I'll try to help. I'll go directly to your specific questions.
1) There are several unusual aspects to your case. The location and description (pubic area, with dark mole-like lesions) are unusual for warts, and it is atypical for genital warts show up so late or to last so long after the apparent time of acquisition. A dermatologist's perspective usually is accurate. Still, I am a little skeptical you have warts. When the biopsy result is available, you should discuss it with the dermatologist and also ask her level of certainty that the other lesions also were warts.
2) The biopsy will be valid only for the site that was actually sampled. The result might influence the dermatologist's opinion about the other lesions, though.
3) Don't over-interpret what you have read elsewhere on this forum. I tell patients that probably they are not likely to infect partners if genital warts are treated, go away, and 6 months later they have not recurred. But that's only an approximation. And your situation is obviously atypical, so I cannot say whether such a guideline applies in your case. In any even, the starting point for such advice is from the time the warts -- if that's what you have -- have cleared up, either on their own or with treatment.
Best wishes-- HHH, MD
1) There are several unusual aspects to your case. The location and description (pubic area, with dark mole-like lesions) are unusual for warts, and it is atypical for genital warts show up so late or to last so long after the apparent time of acquisition. A dermatologist's perspective usually is accurate. Still, I am a little skeptical you have warts. When the biopsy result is available, you should discuss it with the dermatologist and also ask her level of certainty that the other lesions also were warts.
2) The biopsy will be valid only for the site that was actually sampled. The result might influence the dermatologist's opinion about the other lesions, though.
3) Don't over-interpret what you have read elsewhere on this forum. I tell patients that probably they are not likely to infect partners if genital warts are treated, go away, and 6 months later they have not recurred. But that's only an approximation. And your situation is obviously atypical, so I cannot say whether such a guideline applies in your case. In any even, the starting point for such advice is from the time the warts -- if that's what you have -- have cleared up, either on their own or with treatment.
Best wishes-- HHH, MD
MEDICAL PROFESSIONAL
I would rather you speak frankly with your current dermatologist. Feel free to print out my reply, or at least ask the questions it implies: you understand that warts are less common in the pubic area, pigmented (dark) lesions are uncommon, long time since last exposure, etc; and that you want confirmation that the diagnosis of warts is accurate. Raise the possibility of a second opinion, but in a non-challenging way. If your dermatologist is defensive or evasive, for sure get a second opinion. But my bet is that you will find her more reflective than dogmatic.
thank you very much, doctor. Whether I have genital warts or not, this board has made me much more comfortable. I was really scared. I'm still saddened and frustrated, but there is light at the end of the tunnel. You're insight has been a big help.
If you could please indulge me once more:
should I go to another dermatologist and have a biopsy performed on the other two moles? Is it too late in light of the fact that the moles have been frozen? in other words, where do I go from here?
again thank you for your help.
If you could please indulge me once more:
should I go to another dermatologist and have a biopsy performed on the other two moles? Is it too late in light of the fact that the moles have been frozen? in other words, where do I go from here?
again thank you for your help.
You are reading content posted in the STDs Forum
Herpes spreads by oral, vaginal and anal sex.
Herpes sores blister, then burst, scab and heal.
STIs are the most common cause of genital sores.
Millions of people are diagnosed with STDs in the U.S. each year.
STDs can't be transmitted by casual contact, like hugging or touching.
Syphilis is an STD that is transmitted by oral, genital and anal sex.
