Boyfriend has skin infection

[nycgrl40]

My boyfriend recently broke out in a skin rash on his testicle and I'm concerned about it.  It started as a single sore and he went to a walk in clinic to have it checked.  The doctor there looked at it and wasn't sure what caused it.  He asked if it looked like herpes and she said she didn't think so but she did a blood test (herpeselect) and culture.  She thought it was yeast because he also had a rash on his inner thigh and it was interacting with the spot on his testicle.  She gave him a yeast infection cream that did nothing.  A few days later it developed into a skin rash and was kind of oozing and very sore.  His glands were also sore.  It sounded a lot like herpes symptoms so of course we were freaking out.  The blood test came back negative (HSV1 was .23 and HSV2 was .72).  The next day the culture also came back negative.  The doctor he spoke to at the walk in office said to come back so he could take a look at what it looked like now.  He looked at it and another doctor as well and both thought it was some kind of a skin infection and gave him a prescription for cream (not sure what kind).  They both also said it didn't look like herpes.

Well, we were both still nervous and not feeling confident with the walk in clinic so he went to a dermatologist.  He immediatly said it was "acute keratosis" and prescribed an antibiotic and cloderm cream.  He also said not herpes.  The cream burned really badly when he put it on and now the top layer has come off and it's all exposed and raw.  It has been 3 days since the meds and he's still sore in his groin glands.  The sore is oozing.  

First of all, what is acute keratosis and how is it caused?  Also, we are not involved in risky behavior and the only concern I had was that herpes could have been transmitted through a cold sore that I get but I didn't think that had happened.  

I don't want to overreact but I'm still nervous about sex when he's got an oozing sore on his testicle.  I'm also worried about an incorrect diagnosis.

Can you shed any light?

Thanks

[Alan Rockoff, MD]

I think you may have misheard the dermatologist, who probably said, "acute dermatitis," which is what a steroid like Cloderm would treat.  (A keratosis is a wart-like growth.)

It's hard for me to say with confidence, but I don;t think what your boyfriend has sounds like herpes--negative culture, several doctors saying it doesn't look like it, etc.

Still, the inflammation needs to be made to go away, and it sounds as though that isn't happening.  He really ought to contact the dermatologist and tell him that that's the case, so further treatment can be instituted.  

Sorry I can't be more specific.

Best.

Dr. Rockoff

[ryn21]

You can be confident in a doctors diagnosis.  Most if not all doctors are generally overcautious when making a diagnosis, especially for a condition such as HSV.  If the doc said its not likely herpes and if the culture came back negative, then its more than likely if not definitely not herpes.  Judging by his symptoms, I would say he doesnt have it as they arent typical symptoms (check the STD forum in here for some information on HSV. Ask doc HHH in that forum in addition to this derm if it will make you feel more reassurance).  It is most likely a fungal condition as the doctor probably diagnosed it as being (ie tinea Cruris).  A mild steroid cream or anti-fungal cream would clear it up depending on the particular condition (as im sure the doctor prescribed proper topicals).  You should both put HSV out of your mind.  Wait for the derm to respond, but im sure he will reassure you in a similar manner.  Relax, HSV is not the problem.

[nycgrl40]

Thanks for your reply.  I'm relaxing a little bit now but we were pretty stressed waiting for the test results.  I looked up tinea Cruris and he has similar symptoms such as red rash in the crease of his legs but it was the blisters on his testicle that freaked us out.  

Also, the derm. didn't diagnose that, he said acute keratosis.  Maybe that means skin infection.  I don't know.  

It seems to be improving.

Anyway, thanks.

[nycgrl40]

Thought I would give an update.  The original rash on the testicles was improving although the cream took off the entire layer of skin off and it was raw looking.

A bumpy red rash starting spreading down his leg on the same side and I noticed a cluster of bumps on his butt.  

He went back to the Derm who said it's a fungus on the testicle and leg but looked at the butt and said that was herpes.  The doctor is saying the butt and other rash on the testicle and leg are not the same thing.  He saying the testicle and leg is a fungus.  

I don't know what to believe anymore.  It's too coincidental that he has a sore on his testicle and butt at the same time but they aren't related.  Would all of the sores have come out at the same time or is it possible for herpes to break out two different places within 2-3 weeks?  This is also the 3rd or 4th different diagnosis so I don't know what's going on.

We are quite upset about this.  He's really upset and of course I'm concerned about what this means to me.

Anyway, just wanted to update.