Folliculitis or Herpes?

About six months ago I slept naked with man. There was no sexual intercourse but definite skin to skin contact. Exactly one week after I started to get a strange tingling feeling on my right buttocks cheek. This tingling then spread to the inside of my groin and down the back of my leg. A day or two after I felt a stinging sensation in the same area and when I looked in the mirror there were a few red pimple like dots with a whitehead, on different spots on my buttocks cheeks. I have been to 2 different doctors about this as I was concerned it was herpes. The 1st doctor had a look and straight away it cant be herpes but we did a type specific blood test to check. The test came back positive for HSV type 1 IgG (which I do get coldsore very rarely) and negative for HSV type 2 IgG and IgM which she explained to me that, that means my body hasnt produce antibodies for type 2 and that my blood wasnt showing that I was having a HSV type 2 breakout at the time it was taken. Ok so that means I dont have HSV 2. But is it still possible that I could be having a type 1 outbreak on my buttocks even though I know I already have had the virus in the form of coldsores for years....? The blood test doesnt really help as I knew I already was positive for type 1, but that doesnt mean that the symptons im experiencing on my buttocks isnt type 1 does it?
Both doctors said they couldnt do a swap cos the pimple like spots werent open sores. The 2nd doctor was positive that it was folliculitis from just looking at it and told me to wash in pHisohex which contains 1% w/v Triclosan(10mg/mL) and I have been using it twice a day now for almost a month and it hasnt made any difference. The reason why Im so worried about this being herpes is because of the symptons I get before these 'pimples' appear. They include stinging, tingling and burning on the right buttocks. Then the pimples usually appear not long after that. The only thing that doesnt seem to be common for herpes is that the pimples dont ever seem to go away...there is always ay least some irritation there. But the tingling, stinging and burning comes and goes, usually more intense around my period. I hope someone can help me with some answers.....thankyou

[worry_wart83]

Can anyone help me? Any answers?

[worry_wart83]

Does anyone know much info on folliculitis? Ive been reading through the posts and my symptons seem a little different.....My red dots are more like really red pimples with a whitehead and they sting alot. They can appear anywhere on my buttocks some close together some not. I hope someone can help me please......?

[BhumikaMD]

Hi,

This could be sweat dermatitis, folliculitis, allergic reaction. In most individuals there are outbreaks of folliculitis from time to time.

Folliculitis is infection and inflammation of the hair follicles. The condition may be superficial (i.e., on the surface of the skin) or deep within the follicles.The most common cause of folliculitis is infection by the bacteria Staphylococcus aureus.

Folliculitis symptoms can appear independent of infection. Exposure of the skin to certain chemicals, especially oils and tars, can trigger an outbreak. People with depressed immune systems, diabetes, or obesity have a greater risk of contracting folliculitis than the general population.

Patients with chronic unresponsive folliculitis may require investigation into the source of the infection. S. aureus bacteria can live in the patient's nostrils, periodically triggering a folliculitis outbreak.

Individuals who are predisposed to folliculitis should be extremely careful about personal hygiene. Application of antiseptic washes may help prevent recurrences. A topical antibiotic cream, mupirocin (Bactroban®), has been effective at reducing bacterial colonization in the nostrils. It is applied twice daily for a week and is repeated every 6 months.

If there any of the mentioned medical causes then treating those will reduce the occurence of the condition.
http://www.dermatologychannel.net/follicle/folliculitis.shtml

Some stubborn cases of folliculitis have been responsive to laser-assisted hair removal. This process uses a laser to destroy the follicle. This reduces the scarring that results from folliculitis.

Let us know if you need any other information and consult a skin specialist if the lesion is persistent.

Regards.

[worry_wart83]

Can folliculitis cause the tingling and throbbing pain i was experiencing in the same reigon??

[worry_wart83]

Im still getin alot of stinging and muscle pain around my buttocks, down back of leg and in my hip joint. Can anyone please tell me if this is symtons of Folliculitis?? Its driving me mad!!!

[BhumikaMD]

Hi,

Are you on any medications currently? Have you consulted a doctor for your symptoms.

Folliculitis can cause pain, itching and tingling too. a clinical examination is essential for a confirmed diagnosis.

Let us know if you need any other information.

Regards.

[worry_wart83]

Thankyou for your reply. Yes I have seen 2 doctors and one said it was folliculitis and the other wasnt sure. But both were certain it wasnt herpes. They didnt take any swabs though cos they said there wasnt an 'Open Sore' to take one from.....the red dots i get only look like pimples, its the symptons I can feel that bother me. They are quite uncomfortable and feel worse than they look! Its really stressing me. The only med the doctor suggested is that wash i mentioned in my 1st post which isnt working... if you have any other info id greatly appreciate it
Thankyou for all your help = )

[jogger2008]

Do you think it could be shingles?

http://healthlink.mcw.edu/article/1031002332.html

[worry_wart83]

Thankyou for your interest. Im not too sure if it could be that.....I finally had some swaps taken and nothing came up, no bacteria or HSV detected. Its driving me crazy. The doctors still think its folliculitis but they say its not 'severe' enough to medicate me for! I dont know what Im suppose to do. Its constantly there and with the weather getting warmer its gettin more and more irritated! Am I suppose to just go on having to put up with it or is there anything out there that will help get rid of whatever it is.....?

[RNChick]

I agree, it sounds alot lot Shingles to me. Especially with the pain, tingling, and burning that is consistent with Shingles. IF it were Shingles, which is a herpetic virus, it can take a significant time to resolve in some indivuals. I couldn't be sure without seeing it, but you desribe a "pimple-like" lesion. Shingles are characteristically blister -like and form groups/clumps. Basically, you treat the symptoms, and are often prescribed Acyclovir or something similar.

[Basics]

You need Valtrex twice a day for a week.  It sounds very much like shingles which is a form of herpes but not the type you can give to someone.  It comes from stress in most cases.  Good luck!

[slacker101]

If it is Shingles, only one side of your body would be affected..

[worry_wart83]

Ok so its been over a year now and Im still having symptoms. No doctor seems to be able to help me! Im still experiencing the pain, tingling, stinging and burning mainly on my right buttock cheek, in and around my right groin and down the back of my right leg. After this little red pimples appear on both buttocks cheeks. These symptoms come and go but are always kind of there. I experience the sensations more than the visible symptoms appear. Different things seem to tigger the symptoms like sweating but they also appear without any tiggers. I only have to sit for 30min to an hour before I start feeling the pain tingling stinging and burning. Is anyone absolutely sure this isnt Herpes. Ive had a Herpes select blood test and was positive for HSV1 but ive been positive for this for years and occassionly get coldsores. Is it possible to have HSV1 gentially and orally. Does folliculitus (folliculitis) act like this?

[jagesh50]

My opinion is that you have a cholinergic urticara with zosteriform distribution.

[worry_wart83]

Can u please explain what this means?

[jagesh50]

Yes indeed.Cholinergic urticaria is a condition in which sweat precipitates a rash,itch -and pain though rarely.Normally it is a generalized condition,but very rarely it can be dermatomal by which it means along nerve roots.My earlier communication must have read dermatomal and not zosteriform,i stand corrected.

[worry_wart83]

Thanku for your quick response. It kind of makes sense but I dont always just get symptoms after sweating they can come up at anytime. I dont always form pimples but have the tingling burning etc ALOT! What is Zosteriform and what does it mean? Do I have herpes??

[jagesh50]

Sorry that word popped up up,and I stood corrected.By the way herpes is one of the conditions and not THE condition with such distribution.Any way you have no herpes for sure.

[jagesh50]

This is a condition of allergy where cholinergic nerves produce a substance that causes all your symptoms,mostly but not always sweat based.Atarax tab may help 1 at bedtime.

[worry_wart83]

Thankyou again! So I dont have herpes? and I dont have Zosteriform distruibution? Is that correct?
How do I get my doctor to confirm this condition and treat it for me?
Do you have a link where there is info on this condition?

[jagesh50]

Absolutely.I will surely give you some sites.Right now off to office.Adois.

[worry_wart83]

Oh thankyou so much!
Im still not clear on whether I have zosteriform distribution? Can u please clarify....

[jagesh50]

Zosteriform means a nerve root generally on one side only,along the supply route.

[worry_wart83]

So u are comfirming I have cholinergic urticaria zosteriform distribution?
How do I get my doctor to confirm this? and treat me for it?

[jagesh50]

I suggest you meet any good dermatologist in your area an carry forth the suggestions,but even they may need some googling to come to a reasonable diagnosis,in the absence of any other differential diagnosis.But then remember we are in a community forum and I guess you must take all this with a pinch of salt.The picture,however fits in with your symptoms and I stand convinced.Do take care and hope you will recover soon.Sure do get a opinion from the forum consultant who is doing a wonderful job.

[worry_wart83]

I just got back from my GP and she said it very well could be herpes!!! There wasnt anything to swab so she cant confirm this without a positive swab. Ive been testing (through blood tests)positive for HSV1 for years but I DO get coldsores. Is it possible to have HSV1 in both areas? And if so could I be having symptoms this often in the gential (genital) area with HSV1? I thought it didnt break out as often in the gentail area as it does orally.....? Do you have any answers for me? Please help!!

[worry_wart83]

I was just wondering what your thoughts were now I know I dont have folliculitis? This is driving me insane!

[jagesh50]

That you have symptomatic herpes1 gluteal area is most unlikely,and would remain a surmise,because type1 antibodies in blood are mostly aquired by age15.The type1 has predelection for the ganglia of the face areas,though not impossible at genital sites.But too far out to occur in an acute form,relating to minor stimuli like heat or sweat.

[worry_wart83]

Ok so theres no way that HSV1 infection could possibly cause symptoms like these so frequently and quickly? For example as soon as Ive been sitting for 15mins or so I get the burning tingling and pain straight away in the buttocks area. Theres no way HSV1 could be activated this quickly is there?

[jagesh50]

This is what precisely I am trying to drive out.

[worry_wart83]

Ok thankyou so much for all your help = )
My GP has referred me to a dermatologist. Do you think he will be able to help me and get to the bottom of this? Is there medication that he will be able to subscribe if he does diagnose me with cholingeric urticaria? My GP said to try 1 claratyne tablet everyday....

[jagesh50]

Fair enough for now and get the derm opinion.If antihistamine works we would be nearer to the truth.

[worry_wart83]

Hey I was just wondering if you could answer some questions for me in the meantime until I get to the dermatologist.
1. Because Ive tested negative twice to HSV2 blood tests, since I started having symptoms, can we definitely rule out that THAT strain isnt the cause?
2. Because I test positive for HSV1 the last doctor I saw said that THAT strain could very well be the cause for these symptoms. Could this be possible at all? As Ive being testing positive for HSV1 for years and DO get coldsore symptoms. Plus the symptoms I get on the buttocks are almost always there, and a HSV1 infection in the gential (genital) area shouldnt reacurre as much as this should it?
3. Im a little confused as to how people are contracting HSV1 gentially if 90% of us already have this strain orally and should have enough protection against it to stop being infected. What are the chances of my boyfriend contracting HVS1 gentially from me if my symptoms on the buttocks do end up being this? We've being having unprotected sex for 9months as we both have had the all clear for all other std's. His doctor wont do a Herpes Type Specific blood test on him cause he hasnt shown any symptoms and she said its so common that him testing positive for HSV1 wouldnt tell us anything. What do you think?
Thankyou for all your help! = )
Is there anything else that could be causing my symptoms other than cholingeric urticaria?

[jagesh50]

For example, most people infected with HSV-1 in the genital area have few, if any, outbreaks after the initial episode, far fewer than is typical with either oral HSV-1 or genital HSV-2. While experts estimate that some 30% of genital herpes infections in the United States may be caused by HSV-1, only 2- 5% of recurring genital outbreaks are caused by HSV-1. Research conducted by Lawrence Corey, MD, and colleagues at the University of Washington in Seattle shows that genital HSV-2 recurs 10 times more often than genital HSV-1.So your outbreaks frequently in the gluteal area is a myth than reality.

[worry_wart83]

So you really think my symptoms arent being caused by my HSV1 infection? Sorry for keep asking just really trying to get the herpes thing outta my head!!!

[worry_wart83]

Sorry Ive just got one more question after reading some other posts. I started having these symptoms in April 2008. I got Herpes Type Specific blood tests done in Sept 08 and tested positive for HSV1 and negative for HSV2. I got the same tests done again in March 09 with the same results. Am I safe to assume the negative result for HSV2 is correct? (Ive been + HSV1 for years)Did I allow enough time when I had these tests done for anitbodies to show? I was just reading in another post that they could take up to 6months or longer to show......
Thankyou
Oh also how come my tests didnt come back with any n.o's next to the positive and negative results like other peoples? Am I having a diff test done to everyone else?

[jagesh50]

The time taken for positivity,you have adequtely crossed.No worries relax.

[worry_wart83]

Hey Ive started keeping a journal of my symptoms and Ive noticed sitting for a period of time seems to bring it on. In a matter of time usually within the hour the pimples appear. I dont need to be sweating for this to happen either. Do you know of any condition another than cholingeric urticaria that this could be?

[jagesh50]

Cholinergic urticaria is a form of physical urticaria triggered by a rise in core body temperature. Sweating is not a must.Then other conditions may include an anxiety state,neuralgias which may manifest itch.

[jagesh50]

Well,it looks to me that you are still thinking of herpes.Herpes group of viruses make ganglion of nerve roots their home, and known as neurotropic.Once in two or three months they peep out travelling via the nerve fibre and when thus they come out form water filled vesicles,now known as epidermotropic,stay for a few days.Then go back home only to come after a few months,this is known a trophism.Now you understand that herpes virus do not behave the way as in your case it comes out as as an when there is even a small stress.H type1 comes just but once or twice in a lifetime at the genital level.Hope I am clear.

[worry_wart83]

I know I am stuck on herpes just mainly because of the tingling stinging and burning and then the pimples appear. I guess Ill only be able to move on from this when Im diagnosed with something......
What you said in the previous post about heat makes sense but im not getting a itch...Could it be anything else??

[worry_wart83]

Can u explain at all why Im geting the tingling feeling in and around my groin on the same side as my buttocks?
I also havent mentioned that I suffer from vulvodynia. My vulva symptoms have been at ease from sometime now, but could this condition be causing the tingling sensation on my buttocks?
Could I have nerve damage? A week or so before these symptoms started I did alot of bike riding could that have anything to do with it?

[jagesh50]

Neuralgias of lateral cutaneous nerve is known to cause similar symptoms,cause unknown but pressure on the nerve inflames it,possibly bike riding.

[worry_wart83]

and this could cause symptoms that last this long?
Do you think this could be pressurized urticaria?

[jagesh50]

See,even to talk of a localized cholinergic urticarias will raise eybrows, but then neuralgias do last for quite some time and anixiety state will exacerbate symptoms.Best to get the herpes angle fom your mind where the anxiety seems to come from to worsen the simple neuragia.

[worry_wart83]

Why would this raise eyebrows?? I really dont think its anixety induced Even when Im my most happiest symptoms can be at their worst. Sitting down and pressure on the buttocks cheeks seem to be the main cause. Is there anything else that cause these symptoms??

[jagesh50]

Pressure on the nerve and neuritis will be a safe bet.

[worry_wart83]

Well that makes sense for the nerve feeling. But can you explain why these pimples are appearing? They dont come up as a rash they come up as red dots all over my buttocks. Some are a odd shaped red patch with 2 little pus like heads others just look like ordinary pimples i get on my face. I just dont understand why they are comin up? Im not sweating, I shower daily what is causing this????

[jagesh50]

Is it on one side or all over?how long the pustules last?does it that itch that time?Daily or weekly?

[worry_wart83]

They appear on both sides of the buttocks but I only get the nerve feeling on the right. They dont itch at all but are sore to touch just like a pimple is. There doesnt seem to be any sort of pattern with when they appear but its usually after sitting for a long periods of time but they can also appear randomly without sitting. They can last for a few days or even weeks. They dont seem as red or pronounced when I first wake in the mornings. There isnt many days where I DONT have ANY pimples but they DO go away sometimes....

[jagesh50]

May be it is a pure localized phenomenon like a textile dermatitis.Please do not irritated with my differential diagnosis.I am using all my grey cells to arrive at a meaningful diagnosis,to give you relief.

[worry_wart83]

Oh no Im very very appreciated of you and cant thankyou enough for all your help. You re the only person that has listened and is coming up with different ideas as to what it could be. Im happy to explore all possible outcomes to get to the bottom of this.
Thankyou again = )

[jagesh50]

Yes,textile dermatitis is cloth based and in pressure spots develop pustules or rash which last for sometime.Try only white innerclothing for sometime.The features do not fit in with many others so trial and error method is is followed.Thank you for the trust.