Is a Lingual Papule a Sign of HPV Infection After Oral Sex?

Is the granular tissue at the posterior side of the tongue root an HPV infection?

Hello Doctor: About three weeks ago, I had my first one-night stand.
During oral sex, we did not use a condom, but we did use one during vaginal intercourse.
The next day, I felt something was off and immediately scheduled an STD test for four weeks later.
Since then, I have been monitoring my mouth, skin, and genital area for any abnormalities.
During this time, I started to feel inexplicably stressed and have had trouble sleeping at night.

About a week later, I noticed a fleshy, granular growth near the back right side of my tongue.
The growth is painless and does not itch, nor do I feel any foreign body sensation.
(Since discovering it, I have been checking daily for any changes, but I haven't noticed it getting larger or smaller.) Before noticing the growth, I had a gum abscess near my wisdom tooth, which has since subsided after seeing a dentist, but I still occasionally feel dryness in my throat.

I have a long-standing habit of smoking, which I have stopped recently, and I even have thoughts of quitting altogether.
Doctor, could I be infected with the HPV virus? Here are the pictures of the growth I took: https://photos.app.goo.gl/7sBx7GTG9Pjr2EHR7 https://photos.app.goo.gl/fGVecRvBs6APP1JR9

Aqi, 30~39 year old female. Ask Date: 2018/10/09

Dr. Li Jiaxuan reply Otolaryngology

It is recommended to visit a hospital for an examination, as simple tongue inflammation and HPV can sometimes be difficult to distinguish based on appearance.
It is advisable to collect samples for testing.
Thank you.

Reply Date: 2018/10/09

More Info

The concern regarding the presence of a lingual papule after engaging in oral sex is understandable, especially given the potential association with HPV (human papillomavirus) infection. HPV is a common sexually transmitted infection that can affect both the genital area and the oral cavity. While many people with HPV do not exhibit symptoms, certain strains can lead to visible lesions, such as warts or papules.

Firstly, it is important to note that the presence of a lingual papule does not definitively indicate an HPV infection. Lingual papules can arise from various causes, including benign conditions such as irritation, allergic reactions, or other non-viral infections. In your case, the papule you described as being painless and not causing any discomfort is less likely to be a direct sign of HPV. However, it is essential to monitor any changes in size, color, or sensation, as these could provide further clues about its nature.

Given your recent sexual encounter, it is prudent to consider the risk factors associated with HPV transmission. While the use of condoms during penetrative sex significantly reduces the risk of HPV transmission, oral sex without protection can still pose a risk, especially if one partner is a carrier of the virus. HPV can be present in the oral cavity even in the absence of visible lesions, making it challenging to assess risk based solely on physical examination.

You mentioned experiencing a dry throat, which could be attributed to various factors, including smoking cessation, anxiety, or even a mild viral infection. It is not uncommon for individuals to experience heightened anxiety and stress after a new sexual encounter, especially when considering the potential for sexually transmitted infections (STIs). This anxiety can sometimes manifest as physical symptoms, including changes in oral sensation.

In terms of your upcoming STI screening, it is advisable to follow through with the appointment. Testing for HPV specifically can be complex, as there is no routine test for oral HPV in the same way there is for cervical HPV. However, if you have concerns about potential HPV-related lesions, your healthcare provider may perform a visual examination and, if necessary, a biopsy of the papule to determine its nature.

In the meantime, maintaining good oral hygiene, avoiding irritants (such as tobacco), and managing stress through relaxation techniques can be beneficial. If the papule persists or if you develop additional symptoms, such as pain, swelling, or changes in your oral cavity, it is essential to seek further evaluation from a healthcare professional, preferably an ear, nose, and throat (ENT) specialist or a dentist with experience in oral lesions.

Lastly, consider discussing HPV vaccination with your healthcare provider. The HPV vaccine is effective in preventing certain strains of the virus that are associated with genital warts and cancers. Vaccination can provide peace of mind and protection against future infections.

In conclusion, while the presence of a lingual papule can be concerning, it does not automatically indicate an HPV infection. Monitoring the lesion, maintaining open communication with your healthcare provider, and addressing any anxiety or stress related to your sexual health will be crucial steps in managing your overall well-being.

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