Buttocks, HSV1 genital

[tx_motortmarine]

A couple of years ago I was diagnosed with genital HSV1.  I initially went to my general physican because I had bumps on my penis and on my buttocks.  I'm not sure which bumps came first, but at one point I had bumps both places.  The bumps on my penis didn't really look like blisters.  They weren't painful or sore andwere very small and fleshy colored or darker in color.  I had them for at least a month or more before going to the doctor.  The bumps on my buttocks looked like pimples.  They were usually just a red bump or were a red bump with small head on them.  When I went to the doctor, he looked at the bumps on my penis and said they were probably herpes.  He said there wasn't enough of them there to take a sample of and do a culture.  He had me do a blood test, and it confirmed HSV1.  I've never had a cold sore, but have received oral sex from a girlfriend who did have them from time to time.  The doctor gave me Valtrex, and both the bumps on my penis and on my buttocks went away.

It's been two years and the bumps on my penis haven't ever come back.  I take 1 gm suppressive Valtrex daily.  The bumps on my buttocks do come back fairly frequently, at least once a month.  I get them on both sides of my buttocks, my lower back, thighs, and once on my ankle.  With the latest outbreak, they haven't gone away like they usually do.  It's been over a week, and they're still the same size and color as they were when the first came.  I also have them on both buttocks at the same time.

I was at a military boot camp for 5 months, and didn't have a single outbreak.  So I figured the intense physical activity might explain why I didn't have them.  However, I've also maintained a decent level of fitness now that I'm back in the real world and don't have any other immune problems, but I continue to have outbreaks.

I guess my general question is: does all this sound like genital HSV1?

Any other advice or input would be very greatly appreciated.

[Alan Rockoff, MD]

No, it doesn't sound like genital HSV.  For one thing, you don't generally get herpes on both sides of the buttocks as well as on various other body parts.  For another, a positive blood test (as opposed to a culture) for HSV 1 does not tell you anything about where you have herpes, only that you were exposed to the virus somewhere on your body at some point.  (This is not the case with HSV 2).

I'm guessing that some, perhaps all, of what you have represents folliculitis, or blocked pores.  You should see a doctor, perhaps carrying photos of the outbreak when it's at its worst.  Then you'll know what you hav and what you don't.

Take care.

Dr. Rockoff