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Is this an accurate HPV diagnosis?

I’m a 50 year old male who had no previous HPV diagnosis. I shave my pubic area regularly and often get “normal” folliculitis (bumps, sometimes whiteheads, usually with new hair growing, which go away after a few days).

This same situation occurred a few months ago except one bump on the right side of my scrotum didn’t go away. It had two obvious hair follicles in it, which even regrew after I shaved the same area a few weeks later (the bump remained).

A dermatologist thought it could be a wart or sebaceous keratosis. They did cryo, which didn’t help much. It destroyed one hair follicle but not the other, and the bump kind of returned almost to its former size.

A few weeks after cryo I got a biopsy. The diagnosis was Condyloma Acuminatum, with the comment “sections show epidermal hyperplasia, with hypergranulosis and some perinuclear clearing.”

No typing was done to determine the HPV strain, assuming that’s what it was.

Given that every comment I find from doctors on the web (including STD experts whose opinion I paid for before the biopsy) stated that warts do not/cannot have hair growing from them. When I look up what the pathology of a wart is, I see things like “epidermal hyperplasia, parakeratosis, koilocytosis, and papillomatosis” (https://online.epocrates.com/diseases/22834/Genital-warts/Diagnostic-Tests) and I don’t see most of those mentioned on my biopsy report.

So, does it sound like this is the correct diagnosis? I ask because after shaving a few days ago, I now have an almost identical situation developing, this time on the left side of the scrotum. It’s hard to believe that a wart is once again popping up a few days after shaving like this, considering they are not supposed to have hair growing from them, and the fact that my pathology report doesn’t seem to match the criteria I’ve read, makes me wonder if this has all really been something other than HPV.
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1306047 tn?1333243591
Man, it's tough to say on our end. From what you describe, it's plausibly either option. I haven't done much research lately about the terminology of HPV lab reports so I can't talk about what might be wrong with that. My report said they just looked at it under a microscope and determined the cells looked like hpv(or at least that's what I think it said). Without an actual hpv DNA finding, I think a little doubt is normal. Still, hpv is so common and shaving makes you more susceptible to get it transferred with genital contact. I've had hpv so long now that nothing surprises me about it anymore, but that doesn't mean that I know what I am talking about.

I think you should stop shaving for 3 to 6 months and see what you observe. If you have the financial means, get the other biopsied and maybe try a different dermatologist and ask a lot of questions about the lab. You'll probably have to call the lab to get the info on how the determine hpv. I know that's a lot, but if you really want to know, do as much as you can to have faith in the answer you get.

Hope this helps.
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