An ano-genital questions

Doctor,

I have noticed in the past year episodes of a red painful bump in the area behind the testicles and before the anus.  Only one appears at a time and its location varies in this hard-to-reach area, and once we had an appearance on the testicle itself.  From the looks of it, it appears to be an inflammation of a hair follicle.  But often it is difficult to see if there is indeed a hair coming out of it.  There is hair always in the area though.  THere is no head, just a well pronounced bump. And it does hurt.  

Now, I don't want to beat the same dead horse as everyone else, but is herpes a possibility?  I understand that you have declared before, emphatically, that herpes is a cluster of blisters.  However, I've read that it can be a single sore.  My inclination leads toward a follicle episode because it is an area not normally lending itself to sexual contact, unless discharge reaches it (which can carry herpes).

Are boils a possibility.  These are isolated incidents involving only one bump.  Eventually, it justs heals without any breakage or other fanfare.  I just want to know if there are several possibilities for this red bump discomfort.

Take care.  

[Alan Rockoff, MD]

Your description matches that of folliculitis, which is common in the area you refer to, as it is throughout the groin.  Because each lesion is single and painful, herpes is not likely, since herpes produces multiple blisters, and these generally itch rather than hurt.

Nevertheless, to allay your concerns and nail down the diagnosis with certainty, you should have a doctor familar with herpes (STD specialist, dermatologist) examine you when you have a visible lesion.

Best.

Dr. Rockoff