Sexually Transmitted Diseases/Raised brown bumps on pubc area

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Brown Bumps
Brown Bumps  
QUESTION: Hi Mark,

I am a 26 year old male in Long Beach CA and I discovered some bumps on my pubic area about two weeks ago.  They do not hurt, itch, or bother me at all but it's never good to discover bumps down there.  They almost feel like a hard rubber, and when I first felt them I picked one off causing it to bleed.  I did shave with a razor about a month ago for the first time ad I'm hoping it's a razor burn and not and not an STD.  I have been steady with my girlfriend for a year and I just noticed the bumps.

The photo shows the small bumps I am referring to.  The two larger bumps at the bottom right of the photo are moles that I have had for years.

Thank you for your advice :)

ANSWER: Hi Alan,
It's difficult to say what they are without closer inspection. They can be avoided by not using a straight edge razor when shaving-- use a buzz clipper with hair guard, so it looks more like a crew cut!  They may be flat warts, or hair bumps, or something that I can't clearly see.

Good luck!
--mark


---------- FOLLOW-UP ----------

Brown bumps on pubic
Brown bumps on pubic  
QUESTION: Thanks Mark!

It is really kind of you to offer your services to help others you do not know.  Your advice is very helpful and appreciated. :)

So it doesn't look like an STD in your opinion?  I feel like it may be caused by a straight razor shave or friction from intercourse but whatever it is I want it gone.  

If it's from shaving, is it normal to have bumps like this a month after the shave?  If it's warts, are they contagious and how could I have gotten them?  

I know you can't officially diagnose it by looking at the photo but should I be worried and rush to the doctor immediately or is it likely it will go away on its own?

Please take a look at the closer pic and let me know what you think.

Thanks again :)

ANSWER: Hi Again, Alan,
This photo is clearly better!  The bumps appear shiny, like molluscum contagiosum, or hair bumps. They do not appear to be warts. Does your partner have a similar condition? Molluscum is somewhat contagious, and children and wrestlers frequently get them. It can also be sexually spread, but is considered a self limited condition that usually goes away without consequence, although they may require treatment. And hair bumps may need to have the hairs teased away from being ingrown. (pulling the end of the hair away from where the hair is trying to grow into.

Good luck!
--mark


---------- FOLLOW-UP ----------

Genital bumps
Genital bumps  
QUESTION: Hi Mark,

Since we last talked my genital bumps have spread and covered about 20 percent more area of my pelvis.  I have had these bumps for almost 2 months now and went to the doctor to have them diagnosed.  After glancing at the bumps the doctor told me that he believes they are genital warts and I now have an appointment to have them freezed/burned off.  Do you think this diagnoses is correct based on these photos?

I want to know more information about HPV and why my doctor says this is "not a big deal"  What tests can the doctor perform to ensure his diagnosis is correct?

As always thank you for your support as an expert in the field :)

Answer
Hello Again, Alan,
Bumps such as yours that spread so quickly, are probably due to the virus that causes molluscum contagiosum or human papillomavirus (HPV/warts).  Both mollusum and HPV can be treated in the same way, with freezing or similar treatments. The best way to learn about these skin viruses is to conduct a search using medlineplus.gov as your search engine, rather than google, etc.  

http://www.cdc.gov/ncidod/dvrd/molluscum/faq/everyone.htm
http://www.cdc.gov/std/hpv/default.htm
http://www.cdc.gov/std/HPV/STDFact-HPV-and-men.htm

There are no good clinical tests for either of these viruses. A skin biopsy may be helpful, that it is cutting off a piece of skin (causing injury) to make a diagnosis. Frequently, biopsies are examined microscopically, but cannot evaluate for specific virus types without additional expensive testing.

Most of these skin viruses have a potential to create more severe problems, but in reality, usually don't.  In a similar vein, influenza can kill a person, but it usually does not. Follow your doctor's suggestions, but if you don't have your concerns addressed, get a second opinion from a dermatologist.

Good luck!
--mark  

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Mark P. Behar

Expertise

Almost any question or concern about gay men's health issues, sexually transmitted infections, abnormal Pap smears, anal cytology (anal "Pap smears"), etc. There is no such thing as “d/d free” or “clean” (free of infection), so why do so many of us deceive ourselves into thinking that some people are indeed totally free from a potentially infectious disease, like HIV, herpes, hepatitis, syphilis, chlamydia, warts, gonorrhea, etc., just because they say so? Clinical laboratory tests are not perfect, and having a “negative” or “nonreactive” test does not mean that a person is free from infection. Perhaps at the moment the test was taken, the person was uninfected; or, perhaps, the test wasn’t sensitive enough to detect presence of the infection. There is really no way that anyone can determine that they are truly “disease free,” and there are over a hundred of infectious conditions that can be spread without your knowing anything. Rather than trying to “pre-screen” or “serosort” a potential sex-mate with deceptive questions that are impossible to know by today’s technologies, a wiser option may be to consider everyone infected with something, and either use appropriate protective measures (“safer sex”), or accept the responsibility and consequences of possibly “catching” something from someone who’s hotter than expected (pun intended!). There is much research that supports the contention that an HIV positive person reliably taking HIV medications, and having an undetectable viral load, presents a lower risk for transmission of HIV than people who may think or say they are HIV negative, but are not. Food for thought!

Experience

Family Practice PA since 1981; Volunteer Clinician for Brady East STD (BESTD) Clinic, Milwaukee, since 1977; answered STD questions submitted to their web site. Professionally lectured at national and regional Physician Assistant and Nurse Practitioner conferences, and at national gay & lesbian health conferences on topics including HIV/AIDS, herpes, hepatitis, STDs, human papilloma virus (the cause of venereal warts), abnormal Pap smears, gay and lesbian health issues, among others.

Organizations
Co-Founder, Lesbian, Bisexual, & Gay Physician Assistant Caucus of the American Academy of Physician Assistants, Inc.; American Academy of Physician Assistants; Wisconsin Academy of Physician Assistants; National Co-Chair (2012-16), National Association of Black and White Men Together: A Gay, Multiracial Organization for All People (NABWMT)

Publications
Journal of the American Academy of Physician Assistants (JAPA) Q Visions, Quarterly Newsletter of the NABWMT

Education/Credentials
Bachelor's of Arts, 1972 (University of Wisconsin, Milwaukee, WI) Graduate Credits Experimental Psychology, 1972-75 (Tulane University, New Orleans, LA) Physician Assistant, Bachelor's of Science, 1981 (George Washington University, Washington, DC); Masters in Physician Assistant Studies, 2000 (University of Nebraska Medical Center, Omaha, NE)

Awards and Honors
Colposcopy Recognition Award (CRA), the American Association of Colposcopy and Cervical Pathology; Distinguished Fellow, Clinical Preceptor, American Academy of Physician Assistants; Fellow, Wisconsin Academy of Physician Assistants

Past/Present Clients
Brady East STD Clinic, Milwaukee, WI Milwaukee Health Services, Inc. (Martin Luther King Heritage Health Center), Dept. of Family Medicine and Early Intervention Program for HIV Infected Persons

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