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Suggest Treatment For Genital Warts Post Unprotected Intercourse

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Posted on Fri, 12 Feb 2016
Question: Good day to you doctor,

I am consulting you regarding a persistent skin alteration on the glans of my penis. It occurred 3,5 years ago after unprotected intercourse with my girlfriend (picture 1). Due to a false diagnosis (my doctor considered it a fungal infection) I received proper medication not until 1,5 years later (pic-ture 2). The spot then got treated with cryotherapy and vanished after several sessions. However an alteration near the urethra opening and a generally more furrowed skin (in comparison to the left side of the glans) remained and didn't improve through cryotherapy or any other treatment that I have tried till this day (I have them listed in the "What have you already tried"-section). It doesn't hurt, itch or bleed, but since it has slowly grown over the years I'm very concerned it could be another genital wart or worse (pictures 3 to 5).

By the way, I'm in my mid-20s and not circumcised.



Thank you in advance for your help!
doctor
Answered by Dr. VINAY KUMAR (5 hours later)
Brief Answer:
Possibility of a wart, easily manageable

Detailed Answer:
Hello My Dear

Thanks for contacting us.
I am Dr V XXXXXXX a Sr Consultant in Skin and STD.

I have examined the pics under magnification and noted all your concerns. I will help you with the help of my clinical experience and literature studies on the subject.

The overall situation matches closely that of a possible wart (pic 2), and post treatment damage to the skin ( pics 6,7).

I assume that all your STD test results were negative as applied to Syphilis, HIV, HBs, Hereps Genitalis, Chancroid, Gonorrhoea etc

For a patient with this profile, and attending in my clinic, I would have performed detailed examination and suggested the following in all probability:

1 Keep the area scrupulously clean by washing with plain water twice a day.

2 Apply an antibiotic cream like Mupirocin over the lesion to prevent secondary infection since you are uncircumcised.

3 Have the papular lesion,as seen in pic 2, examined in person and removed preferably by Radio Frequency or CO2 laser to ensure its complete removal without a chance for recurrence

4 For shriveled skin, it is expected that it should recover from the shock of repeated interventions and get normal once again. This may take time and patience will certainly pay back well.

I think you can be back to perfectly normal health in a short time and resume all normal activities expected of a person as young as you.

It would be my pleasure to help and guide you further. The only thing that matters is that because of all the events, you just stay vigilant and report any issue to your doctor or me without a hitch.

My best wishes.
Above answer was peer-reviewed by : Dr. Yogesh D
doctor
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Follow up: Dr. VINAY KUMAR (9 hours later)
Dear Dr. XXXXXXX

Thank you for your detailed respond. I’m not quite sure if I understand you correctly: Is your diagnosis of the possible genital wart not only referring to picture 2 (2 years ago), but also to the current condition of the circled areas in picture 3-5 (today)?

If you allow me, I like to ask two further questions to my condition shown in the pictures:

1. I have noticed that the circled area I’m concerned about shows somehow dilated, elongated capillaries (in comparison to the more healthy skin below; see picture 5). Does this prove the presence of genital warts or can be held as an evidence for any other possible disease in the genital area?

2. As shown in picture 7 the skin area I consider as alternated reacted to “Veregen” (I medicated entire glans), a drug specially designed for the treatment of genital warts. Is this a (definite) proof for HPV (although my condition didn’t improve through medication)?

I’m sorry to bother you with my urge for a definite answer, but I have already seen a few doctors in person and almost got as many different diagnoses… Therefore thank you in advance for your patience!
doctor
Answered by Dr. VINAY KUMAR (2 hours later)
Brief Answer:
Pics 3 to 5 possibly treated skin areas

Detailed Answer:
Hello Dear

welcome back.

I have reviewed the concerns and reexamined pics 3,4,and 5: I found no evidence of warts.

1 The areas that show dilated, elongated capillaries signify that skin got damaged in the areas due to chemical or other means but as such has no evidence of an STD including genital warts

2 Area in pic 7 is showing some swelling which does not seem like a wart or HPV infection. It matches an area that has been chemically treated.

I am glad that you asked these questions and have no hesitation in inviting further queries. I wish you very well along with our team.

Best wishes and thanks
Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. VINAY KUMAR (9 hours later)
Thank you for answering all my questions, Dr. XXXXXXX
doctor
Answered by Dr. VINAY KUMAR (3 hours later)
Brief Answer:
You have been very specific and metiiculous

Detailed Answer:
Hello My Dear

I am thankful for your kind words.

For me, it is a pleasure to be interacting and helping individuals like you. You have been thorough and meticulous in describing your condition.

Best wishes from our team and hoping that things fall into place as early as they can.
Note: Hope the answers resolves your concerns, however for further guidance of skin related queries consult our Dermatologist.Click here to book a consultation

Above answer was peer-reviewed by : Dr. Arnab Banerjee
doctor
Answered by
Dr.
Dr. VINAY KUMAR

Dermatologist

Practicing since :1980

Answered : 480 Questions

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Suggest Treatment For Genital Warts Post Unprotected Intercourse

Brief Answer: Possibility of a wart, easily manageable Detailed Answer: Hello My Dear Thanks for contacting us. I am Dr V XXXXXXX a Sr Consultant in Skin and STD. I have examined the pics under magnification and noted all your concerns. I will help you with the help of my clinical experience and literature studies on the subject. The overall situation matches closely that of a possible wart (pic 2), and post treatment damage to the skin ( pics 6,7). I assume that all your STD test results were negative as applied to Syphilis, HIV, HBs, Hereps Genitalis, Chancroid, Gonorrhoea etc For a patient with this profile, and attending in my clinic, I would have performed detailed examination and suggested the following in all probability: 1 Keep the area scrupulously clean by washing with plain water twice a day. 2 Apply an antibiotic cream like Mupirocin over the lesion to prevent secondary infection since you are uncircumcised. 3 Have the papular lesion,as seen in pic 2, examined in person and removed preferably by Radio Frequency or CO2 laser to ensure its complete removal without a chance for recurrence 4 For shriveled skin, it is expected that it should recover from the shock of repeated interventions and get normal once again. This may take time and patience will certainly pay back well. I think you can be back to perfectly normal health in a short time and resume all normal activities expected of a person as young as you. It would be my pleasure to help and guide you further. The only thing that matters is that because of all the events, you just stay vigilant and report any issue to your doctor or me without a hitch. My best wishes.