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Having lesions in genital area. Diagnosed initially as genital warts and later as sebaceous cysts. Prescribed aldara. What to do?

Mar 2013
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Practicing since : 1998
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Is there a way I can find out if I was misdiagnosed for HPV warts? A blood test, a skin test, something?
I went to 5 different doctors, two of whom said sebaceous cysts, first is a PCP the second was a OBGYN, then I was bothered by the lesions, so I went to to a new OBGYN. She thought genital warts and gave me aldara, then after two months, said I cleared, I still saw the same lesions come back, I went back to her but now she said they are sebaceous cysts and not genital warts, then went to two others who confirmed sebaceous cysts, but how do I know for sure whether or not I had the warts to begin with? To me they look the same and I just need to know if there is a way to find out whether or not I ever had the warts, HPV pap came back clear.
Posted Sat, 6 Jul 2013 in General Health
Answered by Dr. Aarti Abraham 1 hour later
Thanks for your query.
Diagnosis of genital warts is usually clinical, made by visual inspection. Genital warts can be confirmed by biopsy, which might be indicated if 1) the diagnosis is uncertain; 2) the lesions do not respond to standard therapy; 3) the disease worsens during therapy; 4) the lesion is atypical; 5) the patient has comprised immunity; or 6) the warts are pigmented, indurated, fixed, bleeding, or ulcerated. Genital warts are usually asymptomatic, but depending on the size and anatomic location, they might be painful or pruritic. The use of HPV DNA testing for genital wart diagnosis is not recommended, because test results would not alter clinical management of the condition.
However, HPV DNA testing is confirmatory of the condition.
The application of 3%–5% acetic acid, which causes skin color to turn white, has been used by some providers to detect HPV-infected genital mucosa. However, acetic acid application is not a specific test for HPV infection. Therefore, the routine use of this procedure for screening to detect mucosal changes attributed to HPV infection is not recommended.
Take care.
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