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What Is The Cause And Treatment For Seborrheic Keratosis?

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Posted on Thu, 17 Jul 2014
Question: Dear doctor I have been diagnosed with a seborrheic wart on my genital area.It manifested two months after I received an oily hand job. There was another client before me and I do not know about the masseuses hygiene.I have never been sexual active .This was my first exposure ever.I never knew about HPV prior to the exposure.I have been highly worried mainly about the high risk strains.The seborrheic wart is about 1 cm in diameter. I want to know which strain it is so that I can get vaccinated.If I get a shave biopsy done can I know which strain have I acquired.I have read that seborrheic wart on the genital can manifest HPV. Can I have any other strain except than that on the seborrheic wart.I mean if I get a shave biopsy done and send it to histopathology and come to know the strain can I have only that strain .is it possible to have more strains on other parts of the skin
doctor
Answered by Dr. Bharatesh Devendra Basti (1 hour later)
Brief Answer:
Excision biopsy not necessary just for HPV typing.

Detailed Answer:
Hai XXXXXXX
Thank you for your query.I am Dr Bharatesh D Basti and I will be answering your query.
Seborrheic wart also called seborrheic keratosis is usually secondary to HPV infection in the genital area.The commoner strains are HPV 6, 11 and are usually benign. These can be due to single or multiple strains.It is difficult to isolate strains many times.
It is better to get a shave biopsy done (if you want to check for HPV strains) and send specimen for diagnosis and typing of HPV strains using polymerase chain reaction.You can also ask for histopathology report for confirmation.
There is a quadrivalent vaccine available which can of be of use to you.Strains in vaccine are 6 ,11, 16 and 18. This can be protect you against cancer causing HPV too.You need not worry about other strains once you are getting vaccinated.
Various modalities of treatment like keratolytics podophyllin resins, Cryotherapy, Immune response modifiers are usually preferred over excision.
Hope I have answered your query.
If you have any queries, please ask again.
Dr. Bharatesh
Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
doctor
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Follow up: Dr. Bharatesh Devendra Basti (24 hours later)
Dear doctor the histopathology is only conducting IHC staining.Can high risk strains also be passed via a handjob. Or only low risk can be passed.I have never been sexually active otherwise.I am very worried about the high risk strains.after conducting a biopsy can I be sure that these are the only strains I have contracted. Can there be other strains too on the skin around. I am highly concerned.please help me .I'm not sure of the masseuses hygiene to her client before me.
doctor
Answered by Dr. Bharatesh Devendra Basti (1 hour later)
Brief Answer:
Excision biopsy to rule out your anxiety.

Detailed Answer:
Hi XXXXXXX
Thank you for follow up question.
I think you have become yo anxious tensed .I understand your situation.
You please go ahead with the excisional biopsy and check for strains.It is highly unlikely to have high risk strains.You also feel relived by getting the results.
The chances of other strains other than in result being present is most unlikely.
You relax .Be free of worries.You can explain to your partner after your results come in a detailed and convincing way.
Enjoy your life with a faithful relation later.
Thank you
Dr Bharatesh
Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
doctor
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Follow up: Dr. Bharatesh Devendra Basti (17 hours later)
Dear doctor when you say that seborrheic wart on genitals is secondary to hpv what does that mean.i am very tensed since 5 months regarding this and have been very upset. A low risk strain is acceptable but I am highly worried of a high risk.further I have also conducted a urethral swab for hpv via dna pcr. I didn't have discharge so saline solution was used.my main concern is the seborrheic wart which might contain hpv infection in it.i have been really worried .
I don't know if dna pcr detection of biopsy will be performed but however a ihc strain test is being performed.i have lost a lot of sleep.please advice me doctor how do I leave this incident behind and if I come to know about the strains present in the wart can I rely on that and move on
doctor
Answered by Dr. Bharatesh Devendra Basti (4 hours later)
Brief Answer:
Rely on test, relax, forget and enjoy

Detailed Answer:
Hi XXXXXXX
Thank you for follow up query.
Please undergo excisional biopsy to relieve your anxiety and worries and get it tested for strains.
We have not seen Hpv strains in such cases that too high risk strains .
Most High risk strains are asymtomayic and go away in 1-2 years and do not cause cancer.
I do not see any reason for you to worry , fear about it so much.
The strains will not change by themselves and become high risk until you have contact fresh infection from new high risk HPV case.
So allay all your fears go ahead with test which will be negative.
If you feel convinced you can close the discussion or else you can ask for further clarification.
Thank you
Dr Bharatesh
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. Vinay Bhardwaj
doctor
Answered by
Dr.
Dr. Bharatesh Devendra Basti

Dermatologist

Practicing since :1998

Answered : 1764 Questions

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What Is The Cause And Treatment For Seborrheic Keratosis?

Brief Answer: Excision biopsy not necessary just for HPV typing. Detailed Answer: Hai XXXXXXX Thank you for your query.I am Dr Bharatesh D Basti and I will be answering your query. Seborrheic wart also called seborrheic keratosis is usually secondary to HPV infection in the genital area.The commoner strains are HPV 6, 11 and are usually benign. These can be due to single or multiple strains.It is difficult to isolate strains many times. It is better to get a shave biopsy done (if you want to check for HPV strains) and send specimen for diagnosis and typing of HPV strains using polymerase chain reaction.You can also ask for histopathology report for confirmation. There is a quadrivalent vaccine available which can of be of use to you.Strains in vaccine are 6 ,11, 16 and 18. This can be protect you against cancer causing HPV too.You need not worry about other strains once you are getting vaccinated. Various modalities of treatment like keratolytics podophyllin resins, Cryotherapy, Immune response modifiers are usually preferred over excision. Hope I have answered your query. If you have any queries, please ask again. Dr. Bharatesh