Brief Answer:
Detailed answer and explanations given below

Detailed Answer:

Hello,

The lesions don't seem to have the typical appearance of warts that happen with HPV infection. Because they are flat red lesions and some have desquamation, if you don't think you have been exposed to risk for sexually transmitted disease, it might helpful to try a combination cream with antifungal and a mild steroid twice a day. The antifungal will help with a possible candida infection and the mild steroid will help with inflammation. If these are the causes of the lesions you should notice improvement within 3-4 days and you should continue the treatment up to 7 days.
If no improvement with the cream you will need to do a medical examination and possibly tests.

Rarely HPV may cause flat lesions, especially when they are just starting but generally they start to raise over the skin and take a cauliflower like appearance with rough surface. To best distinguish HPV lesions if they are flat is having examination with acetic acid and HPV DNA test.

If you think you have been exposed to risk for sexually transmitted infections (unprotected intercourse with new or random partner, or if your partner is diagnosed with a sexually transmitted disease) then you need to see a doctor as soon as possible and consider having some tests to rule out sexually transmitted disease like syphilis, chlamydia, gonorrhea, etc.

If you have lesions in other areas of the body, other then in your genital area, this is an important information for us to know and also how did they start, how long ago, how they are progressing and if there is any itchiness or pain with the lesions, any fever or other accompanying symptoms.

I hope i have answered to your query. Let me know if i can assist you further.
Regards,
Dr. Antoneta Zotaj, General and Family Physician

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Brief Answer:
Antibiotics favor candida infection and can be the possible cause

Detailed Answer:

Hello,

If you have used antibiotics recently is a risk factor for genital candida so it may be related and the lesions can be due to candida because antibiotics kill some of the normal flora as well and may favor overgrowth of yeast. In this case the lesions would have appeared after using the antibiotic.

Did you test yourself for other sexually transmitted disease like syphilis and gonorrhea? HIV and Hep B is always good to test for and rule out if you have been diagnosed with one sexually transmitted disease.

I would recommend you to use the antifungal, it is generally well tolerated and highly effective if it is candida infection. Combining it with a mild steroid (betamethasone thin layer) might help improve quicker and deal with other possible similar conditions. After applying a thin layer of betamethasone you can try a miconazole cream or clotrimazole cream (antifungal) over it twice a day. Please do not use only the steroid (betamethazone) as it might make candida worse if it is alone.

Note: you should not stop the antibiotic because of the risk for candida. it is important to take the antibiotic as prescribed and generally it is needed to stop it only in case of allergic reaction, candida infection is not a reason to stop it. Eating some yogurt might be good to help with the normal flora, especially in your bowel so it is encouraged while you take antibiotics.

If the lesions have been present before the antibiotic then they are not related to it and depending on the duration of the lesions one can consider other diagnosis as well. As explained in the message above HPV can cause flat lesions in few occasions so if the lesions are there for longer than a month you will need to have some tests for HPV (local examination with acetic acid and DNA test for HPV).

I hope i have answered to your query. Let me know if i can assist you further.
Regards,
Dr. Antoneta Zotaj, General and Family Physician

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