Two Kinds of Bumps

[dysfunction]

I'm a sexually active middle aged male. A few weeks ago I developed what appeared to be a boil or blood blister in the upper left pubic area, about the size of a pencil eraser. I thought it was likely an inflamed hair follicle. It healed, but left a lump and a scar. Then a few days ago another one appeared in the lower center pubic area, and after about 24 hours the inflammation went away and it scabbed over.  Then yesterday I noticed two whitish bumps, one on the base of the penile shaft and the other in the middle right pubic area. Both identical in appearance, about 1/8" diameter, hemispherical and smooth as far as I can tell.  I have an appointment with a urologist in a few days, but it's got me worried that all these lumps and bumps are popping up all of a sudden. I keep a fairly close eye on things, so I'm sure these new developments. Can you please put my mind at ease.

[H. Hunter Handsfield, M.D.]

Good show.  I'm sure things will go well from here on out.

[dysfunction]

FYI it was immediately recognized as MC by a dermatologist. He treated them by freezing.

[H. Hunter Handsfield, M.D.]

Probably many people with molluscum contagiosum have no symptoms; you could have caught it from your partner even if s/he had no symptoms.  Other cases may not be sexually acquired, even when they occur in the genital area.

If you have MC, it eventually will go away on its own.  However, treatment speeds it up; if your urologist or PCP were really up to speed on that diagnosis, they would have recommended treatment by freezing, imiquimod [Aldara], or simply opening the lesions and expressing the core are effective.  So it sounds like my original advice about a dermatologist still makes sense, since the diagnosis still isn't clear; and if it is, it seems you were given incomplete advice about therapy.

In any case, MC is completely benign infection with no complications.  Your partner should be on the lookout for similar lesions, but otherwise don't worry about it.

[dysfunction]

My Urologist examined the whitish bumps end of July and basically agreed with you. They haven't gone away, so I recently asked my PCP for an opinion and heard "probably molluscum contagiosum". One of the bumps came apart and it had a small hard white core in it which does indeed make it seem like MC (from what I've read). My partner whom I've been with for nine months hasn't had symptoms since we've been together so I'm at a loss to determine where I got it.  Are they contagious if left intact and/or covered?

[H. Hunter Handsfield, M.D.]

No STD causes the sort of problems you describe, i.e. a sequence of pubic area bumps that develop pus.  This sounds like folliculitis or some other superficial infection, likely due to staph, strep or similar bacteria.  Usually these things aren't harmful in the long run, but still you should see a provider, as you are planning to do.  In the meantime, I see no reason to be concerned about any STD.  (And the fact that it's a new problem of course says nothing about its source.  Any new health problem has to start sometime.)

Urology is not the specialty one normally thinks of to evaluate likely skin infections, even of the genital area.  If you have an ongoing relationship with the urologist and trust him or her, or have other reason to believe s/has experience in this area, go ahead as planned.  But a primary care physician or dermatologist might be a better bet.

Regards--  HHH, MD