Possible Molluscum Infection

[Rkcamfield]

Hi, for the past few months I've noticed some spots that seem to come and go on the backs of my hands and the sides of my fingers.  They tend to last only about a week and then usually go away.  Today, when looking at the one that I currently have on my hands, I noticed it was a dimpled papule about 2mm in diameter.  

A while ago, my girlfriend told me she had noticed what she described as "pimple-like" growths in her pubic area.  We both thought that they were irritated skin or possibly trapped hair follicles from her occasionally shaving or trimming, especially because she first noticed them after shaving one time.  I really took a look at them today because she had noticed that one had shown up on her lower abdomen, over her hip bone and because of that, was thinking it might not be the hair thing.  When I looked at it, I noticed it had a similar look to the lesion on my hand.  Her bumps have been pretty constant in her genital region for about 3 months now, and if anything, a few more have come up (like the one on the abdomen).

We have been dating for a year and have been sexually active exclusively with each other for the entire time.  About 6 months ago, we started having sex without condoms and she developed an infection of Trichomonas vaginalis that I must have brought into the relationship from a previous sexual encounter from before we were dating (she was a virgin when we started dating, and I am 100% sure that she is faithful, which is why I feel so bad about this).  I was never symptomatic with the Trichomonas which is why I was not treated before, but at that time, we were both treated for the trichomonas and are fine now.  We both had and STD panel after and found we had no other diseases.  I don't think they do any test for molluscum though.

The strange thing is that if this is a sexually transmitted molluscum, I find it weird that the lesions that I have are on my hands and the lesions she has are in her genital region.  I do sometimes put my fingers into her vagina before sex, so I suppose that theoretically could be a transmission method.  Today, I did a pretty good look under my pubic hair which is relatively short anyway and again confirmed that I have no similar lesions there.  Shouldn't I have these lesions in my genital area too since we're sexually active (even if they did originally come from somewhere else like my hands)?

I'm just trying to sort this out.  Is this likely something other than molluscum?  Could it be a hand to genitals transmission from me?  And why am I not showing any lesions in my genital region?  What are the best treatment options, or will this really be a self-limited thing?

[Bhupinder Kaur, MD]

Hello,
From the symptoms they don’t sound like molluscum because molluscum is a contagious disease which spreads very fast by skin to skin contact and also through inoculation to other body parts. It can be due to granuloma  annulare or plain warts. granuloma annulare consists of reddish bumps arranged in a circle or ring which may be itchy. Usually it is asymptomatic but due to cosmetic disfigurement topical or oral steroids may be needed. My sincere advice is to get it evaluated from a dermatologist.
I hope it helps. Take care and regards.

[Rkcamfield]

Geez, I forgot to add this too.  The last time I had unprotected sex before having sex with my current girlfriend was in the spring of 2008.  I find it strange that I would first develop these lesions only on my hands over year later.  Also, isn't molluscum transmitted from skin to skin?  So shouldn't she have theoretically gotten them even before we stopped using condoms?  

[Rkcamfield]

By the way, the lesions on both of us are painless and do not itch or burn.  There is no fluid in them and if we pick them, they generally will bleed similar to picking any other skin.  If there is any fluid (which again, I don't think there is), it is clear, and it is in an extremely small volume.