Dr. Rashmi Singh
Dermatology
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hi doctor,
I had a protected sex with escort 15 days ago. We did not kiss or do anything without a condom. Today, I noticed a bump next to my scrotum that looks like a wart. I cannot remember whether it was there before. I just noticed it today and it seems to burn. It terrifies me that it may be a genital wart. But, it is tucked away behind the scrotum where there was never any contact. So, I am hopeful that it is something else. No tests are performed yet. My last STD (Sexually Transmitted Disease) was nearly 4 years ago and came back negative. Please help me.
Hello, Welcome to icliniq.com.
I went through your query and picture (attachment removed to protect patient identity) and honestly it does not seem to be anything related to sexually transmittable disease. It is not a wart too. You did not mention whether it is painful or exhibiting any other symptoms and the consistency of lesion. So, it is impossible to make a diagnosis only with the picture of a raised nodule without close inspection and palpation. I would assume it is a scrotal cyst, which is removable surgically by your dermatologist. Rest assured, once again I would emphasize and the image does not concur with any sexually transmittable disease. Please consult your dermatologist for physical evaluation if you are looking to get rid of it.
Patient's Query
Hi doctor,
Thank you for your reply. I am just so paranoid. While looking last night, I also noticed a painless white splotch on the testicle right next to it. More paranoia. What is that? Even though with condom, if I get infected from my partner without noticing her wart, what would the exposure look like? Also, what are the odds of syphilis or HPV (Human Papilloma Virus)? I think I have ruled out most other ones as they would have symptoms by now. But, I could have missed her chancre spot and HPV that seems really easy to get. I have a marital partner and I utterly cannot risk infecting her. How certain can you be from a limited visual inspection? Is there another view such as close or angle that would assist?
Hello, Welcome back to icliniq.com.
You have described that the contact you had with escort was 15 days ago. It is unlikely that a wart this big will show up that soon. Incubation period of wart virus is minimum two weeks, after which the wart begins to appear. Primary syphilis appears as an ulcer and not as a swelling, neither syphilis nor wart would look like that in any stage. Actually, the lesion does need to be palpated for consistency to determine if it is a cyst or just an enlarged lymph node. Since I can see there is no summit, other possibilities are pretty much ruled out. That can never be a genital wart. I really cannot appreciate the splotch you are talking about in this picture (attachment removed to protect patient identity) though.
Patient's Query
Hi doctor,
Today I have noticed a small common wart on my index finger. The same one I used uncovered in the encounter. It is near the knuckle and looks like a common wart, unrelated. But, again with the paranoia. Help me understand my risk for having contracted the genital form of HPV (Human Papilloma virus). Could the virus have transmitted from her vagina to my finger? If so, can I still treat it with typical over-the-counter treatment? Even more concerning, warts can take an extended period of months to develop. What are the chances I contracted HPV from this encounter? Have I already transmitted it to my marital partner? I peeled off the wart surface already, maybe a bad move. I have attached that picture for your opinion.
Hello, Welcome back to icliniq.com.
Since you have already picked on the surface, it is impossible to tell if it was a wart in the first place or not. Did you notice it just now? Usually, Human Papilloma Virus - HPV enters through the mucosa or small cut, laceration or abrasion in the skin surface. If your skin was intact, there is a next to nil chances of her giving off HPV infection from her genitalia. The chance of infection from genitalia to skin or vice versa is minimal. Now, there are 100 types of HPV. Few affect hand and feet and few affect mucosa, there is very slight overlap.
Patient's Query
Hi doctor,
That is helpful. Last question for now is what is this? It may have been present before the interaction, I did not really notice it until shortly after. I have not worried too much as it has not changed at all. Is this a Fordyce spot or something else?
Hi,
Welcome back to icliniq.com.
For further information consult a HIV AIDS specialist online --> https://www.icliniq.com/ask-a-doctor-online/HIV-AIDS-specialist
Patient's Query
Hi doctor,
Last weekend my right testicle got swollen and became very sensitive. I also had a low grade fever. The fever went away, but it came back today. I have assumed that I had cold or some such. There is no irritation in the scrotal skin, but the testicle has remained warm. I sustained an injury in the area a couple of weeks ago and I assumed the swelling was an after-effect from that. But then, this evening in the shower I began to masturbate as I got erection and I discovered a pimple like bump on my penis shaft. It looks and feels like a pimple, slightly raised and slightly sore to touch. It is like a pimple that is not ready to be popped. Following my sex exposure, such intermittent fever and scrotal swelling made me very concerned. Please review the attached files and advise. If you need better or different pictures then I can provide those too.
Hi, Welcome back to icliniq.com.
I went through your pictures (attachment removed to protect patient identity) and the bump does not look like something bothersome. It just seems like a Staphylococcal infection or any other boil and you can just get an antibiotic prescribed from your physician for that. The testicular pain does not seem related. If it recurs with fever then please get it checked with a surgeon to rule out inflammation of testicles or cord. None of them seem sexually related or transmitted. So, you can allay your fear.
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Dermatology
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