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Q. I have two warts near the vaginal opening. Do I still have HPV despite testing negative?

Answered by
Dr. Dhepe Snehal Laul
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on May 02, 2021

Hello doctor,

Recently I have been tested negative for HPV test (cervical swab) for high and low-risk strains of HPV. I had HPV some years ago (with warts), but after treating warts for a year, the symptoms stayed away. Now I see two tiny flesh-colored bumps near the opening of the vagina (since a couple of weeks ago). Do I still have HPV despite the negative test result (the swab was taken a month ago)?

#

Hi,

Welcome to icliniq.com.

I would like to know more details. I have some questions for you. Do you have vaginal bleeding? Do you experience pain while having sex? Is the lesion pedunculated (an elongated stalk of tissue)? Do you have fever or any other systemic symptoms? Are you Vaccinated?

Hi doctor,

I do not have pain, bleeding, or any other symptom, just the tiny bumps, which I would not even have noticed without a flashlight. I have never been vaccinated for HPV.

#

Hi,

Welcome back to icliniq.com.

A verruca or wart is a small, rough, cauliflower-like growth or a solid blister. Even though the cause is viral, warts are harmless and self-limiting if the strain of HPV (human papillomavirus) is benign (like HPV 6 or 8). The lesions appear as papules or plaque whose surface is irregular, barbed, and scaly. They are usually asymptomatic. Genital warts, in particular, are exuberant, vascular, and profuse. Confirmation of diagnosis comes from microscopy and IHC (immunohistochemistry) of lesions. What is the pattern of the lesion? Is it a filiform warty lesion? Do you have a burning sensation while micturition? Do you have any tingling sensation or pain while urinating? Are there grouped lesions? Please attach pictures (if any) to assess lesions and arrive at a definitive diagnosis. Thank you.

Thank you, doctor,

There is one large bump that I can feel (it is a bit rough), and then it looks like another small bump forming next to it, which does not have a texture yet. Those are the only two that I see. I have attached the photos for your reference.

#

Hi,

Welcome back to icliniq.com.

Do you have any history of unprotected sexual contact with multiple partners within the last two weeks? Since when did you notice the growth?

I saw the picture (attachments removed to protect the patient's identity). There are a few soft pink to skin-colored papules with a warty surface. Differential diagnoses are skin tag, molluscum contagiosum, pseudoverrucous papules, and bowenoid papules. Wart is sexually transmitted and is caused by HPV. The average incubation period is from three to eight months. HPV 6 and HPV 11, 42, 43, 44 are commonly benign and harmless strains causing benign, harmless warts (approximately 90 percent). They have no oncogenic potential. The variants are keratotic genital warts, smooth papular warts, and perianal warts.

In the acetic acid test investigation, 3 to 5 percent acetic acid is applied on the suspicious areas for five to ten minutes. Neoplastic or dysplastic tissues turn white. Serology is of limited value. Detection and typing of HPV DNA (deoxyribonucleic acid) is another reliable investigation.

  • Podophyllin will be applied strictly by the physician using cotton tip swabs once or twice a week for up to six weeks.
  • Imiquimod 5 percent cream, three times per week up to 16 weeks. The applied region should be washed with soap and water after six to ten hours of application.
  • Interferon like 1 percent Cidofovir gel or 5-Fluorouracil cream can be applied once or twice per day until clearance of lesion (ten days).
  • Destructive and surgical procedures like TCA (trichloroacetic acid) 80 to 90 percent solution used, under supervision, cryotherapy at weekly intervals, electrosurgery, CO2 (carbon dioxide) laser, and surgical scissor excision.
  • Podophyllotoxin 0.5 percent solution or 0.15 percent cream, applied with a cotton swab twice daily for three days followed by four days of no therapy. Total of four cycles (home treatment with care).

There are two vaccines available like Gardasil and Cervarix (intramuscular route).

It would be more helpful if you can give more details about your sexual contact and history for further diagnosis.


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