Atypical Herpes?

[pharmer]

I have recurrent blistering (small and generally multiple blisters) outbreaks in the same area on the lateral part of my left bicep, left ear, right abdominal area (near belly button) and lower chin area as well as on my penis.  They are painless to only very slightly painful, and on my arm have left an area of noticible hypopigmentation that has not resolved in over a year.  They follow a predictible course of blistering, scabbing and resolution with no crusting other than scabbing.  They typically resolve through the scabbing phase in 3 to 7 days.  Light scarring and hypopigmentation has been observed in most areas.

The area on my arm was biopsied and tested positive for herpes.  The recurrences are most common on my arm and ear, showing up about every 3 months.  The other areas flare up about 1 to 3 times a year.

In my research on herpes, I find no references to these non-genital or oral areas being so affected by herpes.  Can you give me insight on how the non-genital areas could have been infected.  I understand that the virus enters through abraded skin and most of these areas (arm,ear,abdominal area) have never been abraded or near female sex organs.

If possible, please provide me with references or articles that I can follow up on to find more about this.  Could it be something other than herpes?

Most articles I read describe herpes as painful and non scarring.
I have experienced almost no pain and some scarring, particularily on the left arm.

Your insights will be very appreciated.  I am a medical professional so feel free to be as technical as you like.

Regards



  

[Alan Rockoff, MD]

It is possible to get herpes in multiple sites if the skin has been exposed in several areas.  The most typical situation is that of wrestlers, who get what is called "herpes gladiatorum," a colorful if inaccurate term.  Repeated recurrences can certainly leave long-standing pigmentation, or even scarring.

This is usually herpes type I, not genital herpes (not that it matters.)

If these recurrences are a major nuisnace to you, you can at least consider taking suppressive treatment with an oral antibiotic like Valtrex or Famvir.  These can be taken intermittently as well, at the first sign of recurrence, though this is less effective.

I would discuss these matters with your dermatologist.

Best.

Dr. Rockoff

[dvrdwn]

Both of the medications mentioned are antiviral, not antibiotic meds.  Herpes is a virus and should be treated with antiviral, not antibiotics.  Just wanted to clarify.

Regards.

[Alan Rockoff, MD]

The term "antibiotic" covers both antibacterial and antiviral medications.

Dr. Rockoff

[dvrdwn]

Hmm, I hadn't heard or learned of it used in that way in my medical courses so I looked it based on your comment and found this from "The Scientist".

" An antibiotic is formally defined as a microbial product that kills or inhibits other microbes. AZT and most of the other agents used to treat HIV infections are synthetic molecules. They should rightly be referred to as antiviral agents, antiviral drugs or perhaps antimicrobics, and antibiotic should be reserved for such familiar things as penicillin and streptomycin."

David M. Carlberg, Ph.D.
Professor of Microbiology Emeritus
Department of Biological Sciences
California State University, Long Beach, CA 908

And this from another site:

Antibiotics work in infections that are caused by bacteria. (Also, most antibiotics are not effective against all bacteria, but only against specific kinds of bacteria.) Antibiotics don't work at all in infections that are caused by viruses.

[Alan Rockoff, MD]

OK, point taken.  I won't use the term that way anymore.  Maybe "antiviral pill"?

Thanks.

Dr. Rockoff