Patient's Query
Hello doctor,
I had unprotected intercourse with one of my relatives 14 years ago. I had gone through two to three sets of tests back then, including HIV, and all were negative. But I still have some neurological problems, which started one month after I had intercourse.
The doctor did not find any STDs (sexually transmitted diseases) through the VDRL test (Venereal Disease Research Laboratory test). Four years back, I had safe sex and oral sex with some random girls. At present, I have very small two or three warts on my penis, which a dermatologist said is normal, and it recurs. He prescribed one ointment, and it was gone. It has come back again.
Also, I have a very small white line or a very light patch on the penis. Still having neurological problems (under treatment) for some nerve suppression at the neck level due to a disk. Not sure if there is any link with STDs from back then. I am having a problem with having babies. Therefore, I would like to confirm if I have any STDs.
Please advise.
Thank you.
Hello,
Welcome to icliniq.com.
I understand your concern and will try to help you with it.
I have noted your concern, and I have viewed the images (attachment removed to protect patient identity). I can see a single, skin colored, raised, and round bump on the glans. Perhaps it is a genital wart; however, I request you to kindly upload a few more good-quality and closer images so that I am able to have a closer look and guide you better.
The whitish line on the undersurface of the prepuce is not an STD (sexually transmitted disease). It seems like it is due to Fordyce spots arranged in a linear pattern. Fordyce spots are quite common. They are ectopic sebaceous glands.
As far as your screening tests are concerned, they seem to be conclusive since they were done almost five years after sexual contact and would have certainly ruled out HIV (human immunodeficiency virus) and syphilis. Your neurological symptoms are most likely unrelated.
Thank you for consulting me.
You can always reach me at icliniq.com.
Patient's Query
Hello doctor,
Thank you for the reply.
I have uploaded some more pictures. Kindly verify. Also, please note once again, I had safe sex but also had oral sex (not safe).
Please guide me, if I need to go through some STD-related tests, just to be 100 percent sure. Otherwise, I am a healthy person.
Hello,
Welcome back to icliniq.com.
I read and understand your concern.
I have viewed the images (attachments removed to protect the patient’s identity). Yes, they do seem like warts. What ointment was used for the warts? It is not usual for the infection to recur after so many years.
Perhaps this is a new infection. HPV (human papillomavirus) can also be passed on from receptive oral sex if one of the sexual partners has oral HPV. Oral sex is largely safe as far as the risk of HIV is concerned, though there is a risk of transmission of herpes simplex virus (HSV) from oro-labial herpes infection in the partner performing oral sex.
Looking forward to your response in order to help you.
Kind regards.
Patient's Query
Hello doctor,
Thank you for the reply.
I do not remember the name of the ointment. Probably started with 'Z'. In such a scenario, please guide me regarding the queries below.
Please advise.
Hello,
Welcome back to icliniq.com.
I read and understand your concern.
There is no need to test for HPV type. You may screen for HSV with ELISA (enzyme-linked immunosorbent assay) for HSV type 1 and 2, IgG (immunoglobulin G), and IgM (immunoglobulin M).
I suggest screening for you initially, and if positive, then for your wife too. HPV infection usually resolves within two years, whereas HSV persists and can cause recurrences from time to time. None of these infections affects fertility.
Looking forward to your response in order to help you.
Thank you.
Patient's Query
Hello doctor,
Thank you for the reply.
The test with ELISA (enzyme-linked immunosorbent assay) is not available. Any suggestions? Is the test without that fine?
Please advise.
Hello,
Welcome back to icliniq.com.
I read and understand your concern.
ELISA is the standard screening method for HSV type 1 and 2, IgG, and IgM. I suggest you go to a reputable lab.
Looking forward to your response in order to help you.
Thank you.
Patient's Query
Hello doctor,
Thank you for the reply.
I went to a reputable lab, and it is not available there. I have submitted a sample for the standard method available there; only "HSV type 1 and 2, IgG and IgM".
Kindly advise.
Hello,
Welcome back to icliniq.com.
I read and understand your concern.
Yes. This is the test I am talking about. The method used is ELISA. It is perfectly fine.
Looking forward to your response in order to help you.
Thank you.
Patient's Query
Hello doctor,
Thank you for the reply.
Alright.
Hello,
Welcome back to icliniq.com.
Looking forward to your response in order to help you.
Thank you.
Patient's Query
Hello doctor,
Thank you for the reply.
Please find the attached lab results. The staff also suggested a VDRL test, so I went ahead and did that as well, since the additional cost was minimal.
Kindly suggest the next steps.
Hello,
Welcome back to icliniq.com.
I have viewed the attachment (attachment removed to protect patient identity). Both tests are normal, which is a good thing. That means you only have an HPV infection or genital warts. All STDs have been ruled out by lab tests.
Looking forward to your response in order to help you.
Thank you.
Patient's Query
Hello doctor,
Thank you for the reply.
How should I deal with HPV now, for myself and my wife (if she may be at any risk)? Kindly guide me on how to lead a healthy life going forward. I understand that HPV vaccination is available for both males and females. Would it be recommended for us?
Kindly advise.
Hello,
Welcome back to icliniq.com.
I read and understand your concern.
I suggest you apply Imiquad (Imiquimod) cream every night on the area affected by genital warts. Use it for five days a week (Monday to Friday, and Saturday and Sunday off). The HPV vaccine is recommended before exposure to the virus. They do not treat existing genital warts.
Since HPV transmission is reduced by a condom, you must always have protected sex with your wife. I suggest a Pap smear for your wife every three to six months, as HPV is the most common cause of cervical cancer in females.
Looking forward to your response in order to help you.
Thank you.
Patient's Query
Hello doctor,
Thank you for the reply.
I ordered the medicine as it was not available in the local shops. What ointment to use for the whitish patch I mentioned earlier?
I was wondering how long this virus would remain active, as I did my last oral sex three years ago. I heard the body gets immunity against it.
Also, you mentioned it cures within two years. In case my wife has an infection, how long does it take to get some symptoms? Any signs (scars, warts)?
Do I need to give my wife any medication, ointment, or tests other than regular Pap smears?
Kindly advise.
Hello,
Welcome back to icliniq.com.
I read and understand your concern.
The body's own immunity takes care of the HPV infection. The infection resolves in two years in most infected individuals. HPV infection may be asymptomatic, and the incubation period for warts to develop varies from a few days to weeks.
So, one really cannot tell when and who out of the HPV infected will develop warts. If she does not have any visible warts, then there is no need for any medication.
I request you to kindly upload a few better-quality images of the whitish line. It did not seem a concern to me, but I would like to have a look again.
Looking forward to your response in order to help you.
Thank you.
Patient's Query
Hello doctor,
Thank you for the reply.
In my case, as I informed earlier, I was exposed to oral sex for the last time. Do you think it, based on average cases, should be taken care of by now? I am a bit confused here.
Please find the pictures attached herewith.
Regards.
Hello,
Welcome back to icliniq.com.
I read and understand your concern.
I think this linear lesion, too, is a wart. Most of the time, the infection resolves within two years. However, sometimes it may persist longer, especially if it is HPV type 16, 18, 32, or 33, which are carcinogenic.
Most genital warts (more than 90 percent) are caused by HPV type 6,11, which are non-carcinogenic.
Looking forward to your response in order to help you.
Thank you.
Patient's Query
Hello doctor,
Thank you for the reply.
I will apply the ointment.
Hello,
Welcome back to icliniq.com.
Take care.
Patient's Query
Hello doctor,
Thank you for the reply.
I have been applying the ointment, and so far, five units have been applied in the last five days. I can see they are a bit smaller in size, and the bumpiness has also reduced a bit. I have been given a break of two days.
I have a problem with the white patch I showed you earlier. I applied the ointment on that too, and the skin on that portion has ruptured and turned into a small wound. I am a bit uncomfortable deep inside (sometimes at the urine track).
Kindly suggest an ointment to repair that.
Hello,
Welcome back to icliniq.com.
I read and understand your concern.
Irritation is quite expected with Imiquad cream. Apply T-Bact Cream (Mupirocin) twice daily for a week.
Looking forward to your response in order to help you.
Thank you.
Patient's Query
Hello doctor,
Thank you for the reply.
I will apply that.
Hello,
Welcome back to icliniq.com.
Looking forward to your response in order to help you.
Warm regards.
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