HPV Genital Warts in Vaccinated Young Adult Male

Case at a Glance

A 28-year-old African American male presented with concern about genital warts after his partner was diagnosed with HPV through routine cervical screening. Despite being fully vaccinated against HPV, he developed small lesions on his scrotum that were clinically diagnosed as genital warts through telemedicine consultation.

Patient's Story

The patient reported being in a 6-month relationship when his girlfriend discovered she had HPV through a routine Pap smear. She had no visible genital warts and was vaccinated against HPV. The patient had received the complete 3-dose HPV vaccination series prior to becoming sexually active and had only two sexual partners in his lifetime. Approximately one week prior to presentation, he noticed three small bumps on the lower portion of his scrotum, which caused significant distress and concern about his future sexual health.

Initial Assessment

The patient's primary care physician initially provided reassurance, explaining that HPV exposure is nearly universal and that he should be able to continue his relationship without major concern. When the patient discovered the scrotal lesions, photographs were taken and submitted for dermatological consultation via telemedicine rather than in-person examination.

The Diagnostic Journey

Clinical diagnosis was made based on photographic evidence reviewed by a consulting dermatologist. The lesions were identified as consistent with genital warts caused by HPV. No tissue biopsy was performed for definitive confirmation. The patient expressed confusion about developing genital warts despite being vaccinated and questioned the reliability of photo-based diagnosis without histopathological confirmation.

Final Diagnosis

Genital warts (condylomata acuminata) secondary to HPV infection, likely low-risk strains (types 6 or 11) not covered by the patient's vaccination regimen.

Treatment Plan

Topical treatment was prescribed (specific agent not detailed in case). Patient education was provided regarding the difference between high-risk HPV strains (covered by vaccination and associated with cancer risk) and low-risk strains (associated with benign genital warts). Counseling was given about transmission risks and the generally benign, self-limiting nature of genital warts.

Outcome and Follow-up

The patient remained concerned about future transmission risks with continued unprotected sexual contact with his partner and questioned whether his quality of life would be permanently affected. Additional education was provided that genital warts typically resolve spontaneously and rarely recur, and that the condition should not significantly impact his long-term health or relationships.