Warts or Glands? Conflicting Diagnosis! PICS

**Valkyrie** · 11-16-2017, 09:44 AM

Hello Dermatalk,

I'll start from the top - I was diagnosed with HPV 8 years ago. My warts were located mainly in my pubic area, as well as a few at the bottom of my shaft. I'm 30 years old now, and have only had one small wart in the pubic area a few months ago, probably due to stress and heavy smoking. I've had a girlfriend for 5 years, we've had unprotected sex inbetween treatments, she currently shows zero signs and has normal pap smears. They never had your typical cauliflower shape, although I did pick one once and it grew back with a slightly similar texture to cauliflower. All my warts looked identical to the following pic, and have had 100% success rate with Cryotherapy; they would never grow back in the same spot:

https://patient.azureedge.net/forums...50c820cf66.jpg

Now my current concern - For the past 3 years I have had white bumps growing on either side of my frenulum, and on the breve, that look like white tyson glands. Here are some pics and I'll write in point form how they behave:

PERSONAL PICS

(Note the pics where they look larger/whiter are only after showering and dampness, similar to raisin wrinkles)

https://imgur.com/a/Y1YYc?

-Started with 3 really small white spots, one on breve and two on the right side. 3 years later there's about 10. They seemed to have reached a certain stage and stopped growing/spreading. 6 of then are paired in two's, very close to one another, 2 of them look like joint.
-Zero success rate with multiple and vigorous cycles of cryotherapy, condyline, and aldara. After a cryotherapy session, they don't scab, or fall off, then regrow. The area just gets inflamed, turns red, then they turn white again. Kept the are VERY dry, with foreskin retracted and a piece of paper towel in between the testicles and frenulum. After condyline, they look like they're scabbing, shrink, then return to normal size only 2 weeks later. Aldara also inflmaed the area, with the same results.
-They look much more white and worse after a shower, similar to the ones on my corona which are smaller. Somewhat flexible, and are more white when stretched.
-I punctured these spots gently with a sanitized needle before applying condyline. This didn't help treatment as expected, and the spots never spread (unlike the one in the pubic area which multiplied). Also, considering they are located on my frenulum, you would think they would have spread in 3 years to at least the testicles or scrotum, especially after intense exercising/sweating. Or have even grown much bigger.
I went back to the original GUM/sexual health clinic that initially diagnosed me with warts and have been treating me throughout the years. 1 MD, 2 nurse Practitioners, and a handful of nurses all said they were NOT warts, and just normal penis bumps or glands, and that warts usually have rough textures. I was still worried and went to a dermatologist to get a second opinion. He looked at the spots quickly with his portable Dermatoscope and said it IS warts. So now I have a conflicting diagnosis. I asked him how he knew, and he said that papules/bumps usually do NOT grow on the frenulum. After doing some research, I found this was only true to an extent. Here are some photos I found online that look similar to my current white spots, in order with the ones that look mostly similar to my case:

https://www.racgp.org.au/afp/2013/ma...le-appearance/
http://www.aafp.org/afp/2006/0201/p519.html
http://www.chestersexualhealth.co.uk...10/12/STIs.pdf
http://medical-dictionary.thefreedic...a+of+the+penis
http://wastefulpiece.blogspot.ca/2013/08/
https://plasticsurgerykey.com/sexual...ed-diseases-2/

My current Derm can be hasteful at times, usually rushes me out of the office before I can ask in depth questions. His idea that stuff usually doesn't grow on the frenlum made me not confide in his diagnosis 100%. He also removed a mole once that he thought looked atypical, and it ended up being benign. (Nobody's fault as it's hard to tell sometimes). He also scared me by saying "might turn malignant because they are not responding".
During this time with my Derm I'd periodically visit the Sexual health clinic, and had yet a different MD, two nurse practisioners, and more nurses inspect me. They all confirmed they are again NOT warts. One Nurse Practitioner was actually upset I've been destroying my frenulum for 3 years, and to just stop.
This issue has been a mental struggle. I've asked my Derm for a biopsy, but he said it's very invasive and similar to a punch biopsy we did for my mole. My city isn't the best for health care, all my friends are Doctor's/Nurses and always recommend going up North to a more reputable city.

Recap:

One Derm says they're warts. My family doctor is unsure and says possible pearly papules. 2 online Derm's say ectopic sebaceous glands. At the GUM clinic 2 MDs, 3 nurse practitioners and a handful of nurses all say they are not warts. Some even refused to spray the area and told me to STOP, as they were normal penis bumps.

Who am I supposed to believe? They are too small to do a non invasive biopsy, and even biopsies are not 100% conclusive. The condyline and aldara seems to get rid of them, but they were back in 2 weeks. I even tried putting the condyline on my obvious glands around the Corona, they also disappeared for a couple weeks and returned. It's a disillusion.

I have schedules an appointment with a Urologist and a 2nd Derm for another opinion. Please let me know your thoughts.

Thanks!