Conversation: The conversation between human and AI assistant.
[|Human|] I am a 40 year old female who has never had children and is not very sexually active. I was diagnosed with HPV 3-4 years ago after a routine pap that came back abnormal. My PCP said at that time we would have to keep an eye on it and that it was nothing to worry about. I have been complaining of intense anal itching for years and have been prescribed various steroid creams that do not seem to have any effect on the itching. I had a colonoscopy 3 years ago after finding a small amount of blood in my stool and was diagnosed with minor internal hemroids. I was told it was just a fact of life that I would have itching, and to eat more fiber. Recently (6 months ago) I noticed some irregularity at the opening of my anus (like a vericose vein) and went back to the doctor (who performed the colonoscopy years before) and after a very brief visual inspection with no internal inspection, he advised to just eat more fiber and prescribed another steroid cream (proctosol-hc 2.5%). I have used the cream pretty regularly (6-8 x s a week sometimes multiple times a day) and I find no relief. I literally am losing it, the itching is often so intense that I have to leave stores/public places to urgently address the itching. I often itch so much that I bleed and I am kept up most nights by the unrelenting itch. There is a strange whitish pastey discharge that seems to make the itching more intense that I try to keep clean. (I told all this to the colonoscopy doctor, who seemed unconcerned). I recently noticed the itching seems to have gone from the external area to the internal edge of my anus. Today, while trying to itch the edge of my anus internally i found a smal bump with an irregular surface on the inside of my anus, maybe a 1/2 inch inside and 1/8 inch in diameter, near the external vericose vein like area. It is not painful but it is in the area I have the most itching and I am afraid maybe it is a wart - which is totally humiliating - or a dangerous growth. It is not smooth like hemroids are explained, but solid, hard, irregularly shaped and rough surfaced. My PCP and the colonoscopy doctor have repeatedly done NOTHING about my complaints, and have made me feel very discouraged and hopeless. I am very hesitant to call or see either of them for this bump, as I feel they will say the same thing they have said for years - more fiber and steroid cream - and I will feel VERY awkward asking for such a complete probe to find the growth. My questions are - could this itching and the recent developement of the bump be a serious condition, like anal cancer? how can I get relief from this condition and get some quality sleep without waking multiple times a night itching (procedure/surgery/drug)? Should I find a new doctor(s), and what type of doctor should I consult first (specialist or PCP)? can you advise what procedures/test should be run, even precautionary, so I can insist that they are done? Is a anal pap an option for a woman? Thank you in advance.
[|AI|]  Hello, Welcome to Chat Doctor, Human Papillomavirus (HPV) affects only the skin, and it will be localized to the wart. Once the wart is cleared by topical application of cream you will become free from infection. It is transmitted to your partner, if you indulge in unprotected sexual activity during the presence of lesion. Once the wart is cleared by the topical medicines you can have normal sexual activity, and you will be non-infectious.5% McQuade cream should be applied over the wart on alternate days for 4 months. Before application of this cream you need to apply Vaseline over the wart, and then you have to apply the McQuade cream.Meanwhile you have to boost up your immunity which helps to clear your wart. To boost the immunity you need to take orally capsule Lincoln, daily for 30 days. Thank you.