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Diagnosed with high risk HPV. Colposcopy and biopsy reports show metaplasia and dysplasia or condyloma. What to do?

Dec 2013
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Practicing since : 2002
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Hello. I am a 33 year old female diagnosed with high risk HPV about 2 years ago. I had a colposcopy and then a normal pap smear but then an abnormal (LSIL) one a few months ago. I am not sure if this was the same strain or if I got hpv a second time. I had another colposcopy and the biopsy results came back with some metaplasia but not melanoma. dysplasia or condyloma. My doctor also said she checked for warts but did not see anything. I was also tested for STDs and all came back negative (I did have clamidya at one time but that was negative). I have recently found very small bumps on my inner labia (four slight larger 1mm, two in row on right, smaller row on left) close to the clitoral region. They have not grown, seem fairly symetirical and are flesh colored. They don't seem to resemble vaginal warts but don't look as "pearly" or numerous as vulvar papillomatosis but they do seem to have individual stalks. I also think I have fordyce's spots on my mons pubis area. I know I should trust the results of my very recent colposcopy but I am so afraid of harming someone else with hpv and have a new partner who I care about deeply. He knows about my hpv but I have not said anything about my bumps because I also have a history of ocd and anxiety (currently take zoloft 50mg, some klonpin, and wellbutrin 150mg) and feel this might be a result of that. Prior to my current partner I had not had intercourse for about 6 months. I was also diagnosed with mild endometriosis via laproscopy in 2009. I take continuous birth control for this condition. Thank you for your advice.
Posted Sun, 18 Aug 2013 in Sexually Transmitted Diseases
Answered by Dr. Sanjay Kumar Kanodia 56 minutes later
Hello Madam,

Welcome and thanks for posting your query to XXXXXXX

As per your query you have been diagnosed with high risk HPV about 2 years ago and presently you are quite concerned about some eruptions as well as for your new partner.

I can very well understand your concern as in day to day life if there is even slight unusual thing then we get quite tensed about the same. This is so nice of you that your partner knows about the HPV risk as well as you also care for him deeply.

Now coming to your problem directly. TO guide you most important thing about HPV first- there are almost more than hundreds of Human pailloma viruses been diagnosed till now. Each of HPV have its clinical manifestations.

For the pap smear examination and coloposcopy we actually scan for the possibility of cancer cervix in a female. The HPV mainly responsible for the cancer cervix is by HPV 16 and 18. Whenever we scan if we find this group of virus then we refer this patient as high risk HPV which is totally different from the genital warts.

In your case what I can make out is the presence of HPV 16 and 18 which makes you susceptible to problem of cervix. So what you should understand is that this condition is totally different from genital or any other type of warts. What this means is that this condition is though infectious from female to male but male would not be having warts like situation or at the worst if we say cancerous conditions on clinical grounds. Even in females also most HPV infections are temporary especially in young females like you. The remaining of teh around 70% of infections vanishes in 1 year and rest 90% are gone in 2 years. So kindly relax about this condition.

Now coming on the other condition of some bumps on the inner labia. As per the good decription provided by you, it is too early to diagnose anything for these bumps. I can very well make out that you are quite learned lady and have already searched for the thorn like or acuminate appearance of warts as well as pearly appearance of Mollucum contagiousm. As these are close to 1mm and are flesh colored so these appear to be simple proliferation of oil glands only.

I very often see young patients to be concerned for some kind of warts and other Sexually Transmitted Diseases. But not even one out of ten comes positive for any Sexually Transmitted Diseases on clinical grounds itself for your kind of appearance in these patients too.

So kindly relax yourself for this part of problem also as these bumps also do not appear to be warts or related thing.

Be confident and talk to your partner regarding your concern for him. This will also relieve your anxiety regarding the problem.

I hope these information's will help you. If you have further queries I will be happy to help.

"Wish you good health"

Dr Sanjay Kumar Kanodia
MD (Dermatology and Sexually Transmitted Diseases)
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