Sexually Transmitted Diseases/Warts or not?

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QUESTION: Hi, I'm Mattia and I'm from Italy, Parma. I'm a 20 yeared old male, and about a 1.5 year ago I had genital warts. I got them burned and went for control visits for a time. There are still 3-4 raised spots on my penis but my doctor said they were normal skin variations (the doctor that burned the warts). But another dermatologist said they were warts (she didn't have a magnifying glass or anything, she just kept cleaning her glasses to see it clearly and she was ignorant) so I have doubts.
Also about 2 months ago I started to notice some other variations on my penis.
So I would like to have your opinion on this.

A and G = Those are the ones my doctor said normal skin variations. They are on the same spot where the warts used to be. Doctor said after electrocauterization the skin healed itself like this.
C and B = Those are the ones started 2 months ago.
Thank you from now.

ANSWER: Hi Mattia,
The "new areas" C&B that you see are too small for me to assess properly. They may be normal  variations in the skin (fordyce spots), or they may be warts in very early stages. The other areas you describe look like normal variations in the skin, especially after treatment for warts.  

Good luck!
--mark


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QUESTION: Thank you for your answer,
The photos are really big but when they get resized on website they became small, so I tried to crop the photo to show newly variation better.

Answer
Hello Again, Mattia,
Cropping photo helped alot!
In area marked "A" large circle, three items are visible, at approximately the 12 & 4 o'clock positions (slight flaking, healing areas); 7 o'clock appears to be a wart.
In area marked "A" small circle below the large one, the single area at around the 2 o'clock position appear to be either a wart, or an epithelial skin tag if it feels soft; if it is hard, it is neither; it may be a scar or cystic structure.
In area D, just underneith the frenulum on the glans, there appears to be a normal fordyce spot.
In unlabeled area under D on rim (glans corona), normal pearly papules or fordyce spots.
In area B, rough texture if soft to touch, it's normal skin with just that appearance. If it is firm or hard, than it may reflect healing skin from previous treatment.

Hope this helps!
--mark  

Sexually Transmitted Diseases

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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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