Does this sound like Herpes Initial outbreak?

[WorriedandSick]

Dear Doctor,
30 YO male, here.  Approximately 6 weeks ago I had unprotected oral and protected vaginal sex with someone not known to me.  2 weeks later, I noticed some redness and itching on the underside of my penis where the shaft and scrotum come together.

Thinking it was jock itch, I applied OTC topical lotions.  several days later, I noticed bumps appearing on my hands, particularly between the fingers, with little tracks running between them and severe itching, especially at night.  The itching on my penis continued, and I noticed small hairline tears in the skin of the underside of the shaft, and a band of redness about 1/2 way around the circumference of the underside and running up to the head in a thin line on the mid-point of the underside itself.

A week later, with no improvement and continued itching, I went to the local STD clinic.  They took cultures for Chlamidia, Gonnerea, and Syphilis, and took skin scrapings from one of the tears to look under a microscope- saw no signs of white blood cells, bacteria, or "bugs"-- but the doctor suggested Scabies could be the cause.  (the results of the Chlamidia, Gon., and Syph tests have since come back negative).  I went also to a private testing clinic and had them draw blood for a full STD Screen including HIV and HSV II.  Testing was 1 and 1/2 weeks after initial symptoms and about 4 weeks after potential exposure-- both came back negative.  

Right after getting the negative STD results (last week), I went to the dermatologist who diagnosed Scabies and gave me permethrin, which I used and the itching subsided substantially almost immediately.  Since it is our family dermatologist, I did not make him aware of my STD concerns.

Now, one week later, i have noticed the skin where my legs meet my groin on both sides is peeling a little and a red streak seemed to run around the folds of the skin there back towards the perianal region.  as I was examining thes red streaks, one of them actually tore a little towards the back side where the leg and genital region meet-- it looks like a shallow scrape.  I also noticed the skin around my anus and in between my buttocks looked unusually red although it isn't sensitive.  I had not sensed any of the symptoms of scabies in this area at all prior to the treatment so these are all newly affected areas as far as I can tell.

At no point have I seen any blisters or other types of sores during this entire saga, other than the tiny tears on the penis and the new red lines.  The tears on the shaft of my penis are better but not fully healed.  So, I am obviously concerned-- does this sound like Herpes to you?  

[Alan Rockoff, MD]

No, it doesn't.  It sounds like scabies, properly treated.  The peeling in the groin sounds like nothing more than chafing.  Even if you didn't raise the question of STD, your dermatologist would have examined you for it.  Your symptoms don't match those of herpes.

Take care.

Dr. Rockoff

[Birdshit]

About 3 years ago I had some unprotected sex with a women in Hong Kong. I noticed a feeling like a draft in my penis. Thougt I picked up a cold or something. From then on I seem to get more aroused almost like iritated. Thought I might have developed "Spanish fly". Took lots of Herbal stuff tried almost everything for Mens health. Seem to get it under control. Over the last 6 months I developed a Prostate infection which did not affect me Sex drive. In a way it made it worse.
The Doctor put me on Antibiotics. It help for a while but as soon as I had sex without condom I developed a very active Prostate and a slightly itchy Penis and have a slight discharge which smells a little bit. Sometimes I cannot feel anything at all.
Since that time 3 years ago, I aways seem to have a problem.

[WorriedandSick]

Thanks Doctor for your response.  I have a follow up question if you don't mind.  The Permethrin seemed to work for a while, the itching in my hands and penis went away and the scabies marks on my hands healed nicely.  The skin tears on my penis shaft improved but never fully heave healed yet, although the itching went away.  THEN I had a recurrence of the signs of scabies in my hands last week (about 2 weeks after initial treatment), not as severely so retreated all over with permethrin Thursday and they seem to have gone away, but the itching/stinging in my penis and those skin tears seem to have gotten worse again.  Naturally, i don't know what to do-- I spoke to the dermatologist and he still thinks scabies and that I got reinfested by the sheets or because my partner didn't treat herself (she said she had no signs of scabies and had had them once long ago, so knew what the signs would be). He says that the scabicide is pretty much 100% effective otherwise.  I am still worried that this could be a correct diagnosis of Scabies on my hands but that it could still be herpes on my penis.   The little skin tears --10 or 15 of them are about 1/4" to 1/3" long and run parallell to each other along the skin inderneath the shaft of the penis where it is bunched up where the scar from circumcision is.  they itch/sting a little bit, but no sign of any oozing or blood-- just shiny "underskin" where it is torn.  What do you think?

[scaredlikeneverbefore]

A related discussion, Do I have Herpes was started.