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Dr. Andrew Rynne

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Hi Dr. Kumar! You helped me recently with a question

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Dr. Naveen Kumar

ENT Specialist

Practicing since :2001

Answered : 2408 Questions

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Posted on Sat, 29 Dec 2018 in General Health
Question: Hi Dr. Kumar! You helped me recently with a question I had pertaining to a nodule which was discovered in my left nasal vestibule, which had shown up on a CT acan of my paranasal sinuses. The CT report showed a soft tissue nodule in the left nasal vestibule abutting the septum and lateral wall, without evidence of erosions. I visited an ENT surgeon last week regarding the same, and he did a biopsy, for which I am waiting for the results. He did indicate that it appeared clinically to be benign and he suspects it is a papilloma. I had visited another ENT previously, who thought it was an inverting papillloma, and she actually referred me to this other ENT. He told me that the inverting type would not be in the area where mine is located. After googling (I know, that’s a bad thing to do!) I see that there are three rare types of nasal papilloma, including the inverting type, but those appear mostly in the mucousal epithelium located further back in the nasal cavity. I believe my ENT suspects that this is the more common squamous papilloma due to its location. In any respect, he said it could be caused by prior trauma and consist of granular (?) tissue, or it could be caused by HPV. You may recall I asked you a prior question about HPV, as I was concerned that a plantar wart implantation therapy which my podiatrist performed for some plantar warts I have may be connected (I asked the ENT and he said they are not). Since I have health anxiety and have googled these things, I have a few additional questions that I didn’t think of until after my appointment with the ENT:
1). The consensus seems to be that the plantar wart implantstion wouldn’t have caused the nasal lesion, but could I have possibly spread the virus by touching the plantar wart and then the inside of my nose? I know there are numerous types of HPV and I would think the plantar and nasal strains are different...
2). Am I at risk of spreading the HPV from my nasal papilloma (if it is viral in origin) to other areas? Now I’m paranoid every time I blow my nose. Also, last night I think I swallowed what was a piece of perhaps the dried up tissue or blood from the biopsy site and now I have anxiety induced visions of it spreading lesions in my esophagus ofnwherecer (yes, can you tell I’m just a little anxious and stressed over this lol?)
3) Finally, now that I have both plantar warts (that haven’t responded to treatment) and the nasal papilloma possibly caused by HPV, I’m paranoid that I’m going to have these warts and papillomas growing all over...yikes! Do you think it’s just a random occurrence that I have these existing ones and there’s no need to stress over the prospect of other ones? I’m essentially healthy and only have fibromyalgia, high blood pressure, and I did have mononucleosis decades ago...
Thank you for always being there and for any reassurances you can provide!!
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Follow up: Dr. Naveen Kumar 0 minute later
Hi Dr. Kumar! You helped me recently with a question I had pertaining to a nodule which was discovered in my left nasal vestibule, which had shown up on a CT acan of my paranasal sinuses. The CT report showed a soft tissue nodule in the left nasal vestibule abutting the septum and lateral wall, without evidence of erosions. I visited an ENT surgeon last week regarding the same, and he did a biopsy, for which I am waiting for the results. He did indicate that it appeared clinically to be benign and he suspects it is a papilloma. I had visited another ENT previously, who thought it was an inverting papillloma, and she actually referred me to this other ENT. He told me that the inverting type would not be in the area where mine is located. After googling (I know, that’s a bad thing to do!) I see that there are three rare types of nasal papilloma, including the inverting type, but those appear mostly in the mucousal epithelium located further back in the nasal cavity. I believe my ENT suspects that this is the more common squamous papilloma due to its location. In any respect, he said it could be caused by prior trauma and consist of granular (?) tissue, or it could be caused by HPV. You may recall I asked you a prior question about HPV, as I was concerned that a plantar wart implantation therapy which my podiatrist performed for some plantar warts I have may be connected (I asked the ENT and he said they are not). Since I have health anxiety and have googled these things, I have a few additional questions that I didn’t think of until after my appointment with the ENT:
1). The consensus seems to be that the plantar wart implantstion wouldn’t have caused the nasal lesion, but could I have possibly spread the virus by touching the plantar wart and then the inside of my nose? I know there are numerous types of HPV and I would think the plantar and nasal strains are different...
2). Am I at risk of spreading the HPV from my nasal papilloma (if it is viral in origin) to other areas? Now I’m paranoid every time I blow my nose. Also, last night I think I swallowed what was a piece of perhaps the dried up tissue or blood from the biopsy site and now I have anxiety induced visions of it spreading lesions in my esophagus ofnwherecer (yes, can you tell I’m just a little anxious and stressed over this lol?)
3) Finally, now that I have both plantar warts (that haven’t responded to treatment) and the nasal papilloma possibly caused by HPV, I’m paranoid that I’m going to have these warts and papillomas growing all over...yikes! Do you think it’s just a random occurrence that I have these existing ones and there’s no need to stress over the prospect of other ones? I’m essentially healthy and only have fibromyalgia, high blood pressure, and I did have mononucleosis decades ago...
Thank you for always being there and for any reassurances you can provide!!
doctor
Answered by Dr. Naveen Kumar 2 days later
Brief Answer:
Different strains of HPV have affinity towards certain parts of the body

Detailed Answer:
Hi

Thanks for writing back. My sincere apologies for the delay in replying, due to my personal engagements.

1. There are over 150 distinct strains of HPV and they all prefer certain body parts and skin types. For instance, HPV-1 has an affinity towards the foot and causes plantar warts while HPV 6 and 11 cause genital warts. Hence, it is unusual for the plantar warts to infect the nose.

2. There are no records available showing the spread of papilloma of the nose to the other sites in the body. Even, if you happen to swallow the nasal secretions, it would not affect the other sites of the gastrointestinal tract.

3. The nasal lesion can be confirmed as a papilloma only after examining the lesion through the microscope after excision. In case, if the nasal lesion turns out to be a papilloma it would be a rare coincidence to have plantar and nasal wart. Trust me, both the lesions are harmless.

4. Finally, a word of advice. Do not worry too much about this. The undue stress you take, could lower the immunity levels in the body and invite unwanted health related issues.

Hope this answers your query. Wish you good health.

Regards
Dr. Naveen Kumar N
ENT and Head & Neck Surgeon
Above answer was peer-reviewed by : Dr. Prasad
doctor
doctor
Answered by Dr. Naveen Kumar 0 minute later
Brief Answer:
Different strains of HPV have affinity towards certain parts of the body

Detailed Answer:
Hi

Thanks for writing back. My sincere apologies for the delay in replying, due to my personal engagements.

1. There are over 150 distinct strains of HPV and they all prefer certain body parts and skin types. For instance, HPV-1 has an affinity towards the foot and causes plantar warts while HPV 6 and 11 cause genital warts. Hence, it is unusual for the plantar warts to infect the nose.

2. There are no records available showing the spread of papilloma of the nose to the other sites in the body. Even, if you happen to swallow the nasal secretions, it would not affect the other sites of the gastrointestinal tract.

3. The nasal lesion can be confirmed as a papilloma only after examining the lesion through the microscope after excision. In case, if the nasal lesion turns out to be a papilloma it would be a rare coincidence to have plantar and nasal wart. Trust me, both the lesions are harmless.

4. Finally, a word of advice. Do not worry too much about this. The undue stress you take, could lower the immunity levels in the body and invite unwanted health related issues.

Hope this answers your query. Wish you good health.

Regards
Dr. Naveen Kumar N
ENT and Head & Neck Surgeon
Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Naveen Kumar 29 minutes later
Oh Dr. XXXXXXX -- I cannot begin to thank you enough for your kindness and reassurances -- it has truly meant the world to me and has allayed my fears. I obviously suffer from health anxiety, for which I am taking medications and receiving therapy, but when these various health issues arise, I certainly overthink and over analyze them. Of course, when you factor googling these things and the oftentimes irrelevant and scary information that leads to, it can be a recipe for disaster! And yes, I was thinking exactly what you mentioned in your last comment -- the anxiety and stress I'm bringing upon myself is most certainly affecting my immune system. You are truly a special, kind and compassionate doctor, and I cannot thank you enough for being there for me -- I'm sending you a big virtual hug! Have a wonderful day :)
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Follow up: Dr. Naveen Kumar 0 minute later
Oh Dr. XXXXXXX -- I cannot begin to thank you enough for your kindness and reassurances -- it has truly meant the world to me and has allayed my fears. I obviously suffer from health anxiety, for which I am taking medications and receiving therapy, but when these various health issues arise, I certainly overthink and over analyze them. Of course, when you factor googling these things and the oftentimes irrelevant and scary information that leads to, it can be a recipe for disaster! And yes, I was thinking exactly what you mentioned in your last comment -- the anxiety and stress I'm bringing upon myself is most certainly affecting my immune system. You are truly a special, kind and compassionate doctor, and I cannot thank you enough for being there for me -- I'm sending you a big virtual hug! Have a wonderful day :)
doctor
Answered by Dr. Naveen Kumar 7 minutes later
Brief Answer:
Wish you the best...

Detailed Answer:
Hi

My heartfelt thanks for your wonderful feedback.

I wish you overcome your stress and anxiety at the earliest and start enjoying the bountiful blessings the almighty has bestowed upon us.

Always, stay happy and cheerful. My best wishes with you forever. God bless you with a healthy and prosperous life. You too have a wonderful day.

With best regards
Dr. Naveen Kumar N
ENT and Head & Neck Surgeon
Above answer was peer-reviewed by : Dr. Prasad
doctor
doctor
Answered by Dr. Naveen Kumar 0 minute later
Brief Answer:
Wish you the best...

Detailed Answer:
Hi

My heartfelt thanks for your wonderful feedback.

I wish you overcome your stress and anxiety at the earliest and start enjoying the bountiful blessings the almighty has bestowed upon us.

Always, stay happy and cheerful. My best wishes with you forever. God bless you with a healthy and prosperous life. You too have a wonderful day.

With best regards
Dr. Naveen Kumar N
ENT and Head & Neck Surgeon
Above answer was peer-reviewed by : Dr. Prasad
doctor
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