Genital Molluscum or Genital Warts?

[The Hamburglar]

Dear Dr. Handsfield,
Question about differentiating between MCV and Genital Warts, as it applies to my case.

I saw a dermatologist about a 1-2 millimeter black mole-like blemish appeared at on my glans, about a half cm from my penis base. He classified it as a genital wart and lasered it off. About 5 days later, more of these tiny mole-like blemishes showed up near my penis base. Then a bunch on the underside of my penis appeared.

I have another appointment with a different dermatologist because i believe the first dermatologist may have erred in his diagnosis. I can't find a single picture of genital warts that looks similar to my case, because of the dark pigmentation of the blemishes and their small size.

I have tan skin, so my penis's skin is brown, much darker than that of a Caucasian's. I have about 20 total growths on my penis, all of the growths are very dark - nearly black - and slightly raised and clustered. They are also all very small, only about 1-2 mm in area and look like tiny moles or raised birthmarks, nothing like the cauliflour-like postules that are typical of warts. What I have are circular, but some are more elongated in shape. They are easy to spot because they are so dark, if they didn't have the black pigmentation I would just think they were stuffed follicles. .

Also, I didn't realized this until last night, but the pigmented blemishes can be scraped off with a hard metal edge.

1) Does this sound like MCV or HPV?

2) Are there any questions or tests you can recommend I ask of my dermatologists to confirm the diagnosis?

Thanks

[Edward W Hook, MD]

Your lesions sound far more like warts than molluscum.  Remember, for the warts you find photos of to get big enough to be good demonstration material they need to grow.  Warts start small and grow.  In addition, it is not at all unusual for warts to be somewhat darker in color than the surrounding skin.  Finally, whether they were warts (as I suspect they are/were) or molluscum, laser therapy should be effective.  The ones that appeared after your initial therapy were likely growing at the time your first one was treated.

One more thought, perhaps these were neither warts, nor molluscum. working with the dermatologist (your original one or a new one) should help sort this out.

Please us us know what the dermatologist says.  EWH

[The Hamburglar]

also, the blemishes are completely dry and neither itchy nor painful.

[The Hamburglar]

also, the blemishes are completely dry and neither itchy nor painful.

[The Hamburglar]

Thanks Dr. Hook,
Turns out they are indeed warts. I have very dry skin, so the wart spores broke through my skin and were easily exposed. This was the reason for the black dots. Thank you for your commentary.

Hammy

[Edward W Hook, MD]

Thanks for the follow up.  Glad you got things ressolved,  EWH