Genital Warts, Molluscum or What?

[nethealth]

In late March of 2008 I had unprotected sex with a girl and in late April I began to show some symptoms. I began feeling a burning sensation on my inner thighs and noticed some small red bumps appear at the base of my penis and scrotum as well as inflamed lymph nodes on my inner thigh.  In May, shortly after I developed symptoms, I went to the doctor and I asked to be tested for STD's including HIV. All test came back negative and the doctor diagnosed the condition as Molluscum and prescribed Aldara. The burning went away but I still have the bumps to this day and I also developed some bumps that look like Molluscum on my arms and neck. The Aldara suppressed the bumps temporarily but they have continued to go away for a month or two at a time and then re-appear. I have seen another doctor a few times. He diagnosed the bumps as Genital Warts and he treated the bumps with acid. The bumps have not re-appeared in the acid treated areas, but they have appeared in different places around my penis. To sum things up, the doctors I have seen don't seem to know what I have and I still have the bumps nine months after their appearance. Does anyone have any ideas?

[Edward W Hook, MD]

I thnk that varies from locale to locale.  I work in an STD Clinic so my bias is to start there.  it is cheaper, easier to get into and clinicians in these setting tend to be very good.  In smaller towns STD Clinic staff may be a little less experienced.  If they are unsure, then go to a dermatologist.  There is excellent care availabe through either approach.  EWH

[nethealth]

Doctor Hook,

I really appreciate the help that you have given me and I have one last question for you. In your opinion would it be more beneficial to see a dermatologist or to go to an STD clinic?

[Edward W Hook, MD]

Comment:  Much folliculitis does not have hairs sticking out of them.  I bet that is what is going on.

You can call your local health department and ask where their STD Clinic is.  As for a dermatologist, as your friends or someone you know who is is in a medical field.  EWH

[nethealth]

You are correct that the doctor is not a specialist in this area. The first doctor that diagnosed me with having molluscum also said I had some mild folliculitis. However, the bumps don't have a hair protruding from their center nor do they burn or itch as the symptoms suggest.

As you mentioned, I think that seeing a specialist whether dermatologist or STD clinic is the best course of action. How can I go about finding a specialist in my area?

[Edward W Hook, MD]

Unless a doctor is a dermatologist or STD specialist, many doctors don't spend a ton of time looking at their patients' genitals.  What you describe sounds in location as though it could be folliculitis although molluscum is a possibility as well.   Molluscum might well respond to Aldara or topical acid wart treatment but would be likely to recur.  The same is true for folliculitis.   Either of these tend to recur and occasionally can crop up in different locations.  They really sound little like warts at all.  

I doubt that these problems, whatever they are, are related to your exposure in March and they are not typical STDs and are more of a nuisance than a hazard to your health or to sex partners.   I think that you noticed them after the exposure you describe is more likely to be coincidence that causation.  

My advice would be to have a dermatologist or someone at your local sTD Clinic take a look.  Hope this helps.  EWH