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Followup to Red Bumpy Rash on Buttocks - Herpes?
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Followup to Red Bumpy Rash on Buttocks - Herpes?

Dr. Rockoff,
   Thank you for your earlier response. I went to dermatologist last Thursday, about two days after I noticed rash. Saw two doctors in the office who said it probably wasn't herpes. I decided to have a biopsy done. But I don't get the results for two weeks. I am literally paralyzed with fear. Here are my questions:

1. Most of the information on the internet says that a visual diagnosis, even by experts, is almost meaningless, because herpes can loook like just red bumps, etc. and THAT THIN-WALLED BLISTERS OFTEN DO NOT DEVELOP AT ALL, just a red rash.
*In your clinical experience, have you EVER seen any herpes cases, especially on the buttocks, that were like what I described in my earlier post????* Have you seen many atypical cases that did not fit the classic symptoms?

2. The doctor took a biopsy on Friday, over 3 days after I first noticed the rash, and the rash was still red but well on its way to healing. How accurate would such a biopsy be by then? What kind of lab tests are usually done on such a biopsy, because supposedly cultures are no good after rash starts to heal.

3. I began using OTC hydrocortisone cream 1% (Cortaid), on second day of rash, and the doctor gave me Clobex lotion on third day. But rash had already started to heal from just frequent washing with soap. It continued to improve after using the Hydrocotisone and later, the Clobex. Is it true that if the rash was herpes, using hydrocortisone ointments on it would have probably made it worse?  Since it didn't get worse, maybe it wasn't herpes?

4. The only sensation to the circular red welts (one of them almost looked like a red/pink keloid scar until it started to recede), was some itchiness - no pain, BUT i did have a slight tingly feeling in the area (base of spine/upper buttocks) for maybe a minute or so about 12 hours before I noticed the rash. This terrifies me because it sounds like it might point to a herpes prodrome. But it only tingled for a minute?  

5. When I first saw rash, I put alcohol and hydrogen peroxide on it several times. I'm now worried that maybe I changed the course of the rash by drying it out with the alcohol, and that's why no visible blisters developed. Is that likely?

Please help me doctor. I'm so scared and confused.
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1.  If I did, I don't recall.  Basically, the tests will tell the tale, so why speculate?
2. Are you sure you mean a biopsy (piece of skin) rather than a culture.  Either one should be reliable at that stage.
3. Not really.
4. Doesn't sound like a prodrome to me.
5. No.

I suggest that, in addition to culture (biopsy?) your doctor also get a type-specific herpes antibody titer for genital herpes.

I think you will find that you don't have herpes.  If that turns out to be the case, you should take the reassurance and move on.

Good luck.

Dr. Rockoff
2 Comments
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I went through the same thing you're going through..I'm a Guy as well...I suffered with a Red-Bumpy-itchy Rash around my Buttocks for MONTHS...I just thought the dang thing would go away..I don't know why WE men are so hard-headed...Sometimes it would itch like crazy,then other times it wouldnt...Sometimes that red area would dry out & it would feel rough to the touch...

I finally got tired of the itchy-feeling and went to my Primary physician..She sent me to a GREAT Dermatologist..I had to Lay across the table as he examined my naked Butt..At first sight he said it looked like a Yeast Infection....He said it could also be ONE of 2 problems...He asked me what soap i used(Lever 2000-with-Vitamin E) & then he asked me if i used any other creams or lotions in that area...From time to time I do use an African-Body Oil to keep my entire body Moist(twice-a-week-tops)...

He told me to stop using the Oil in my buttocks area..My skin could be too sensitive,which could cause the break-outs..#2,he told me to stop using the Lever 2000 in the buttocks area and he gave me a sample of CETAPHIL,which is a gentle skin cleanser to use for the buttocks...

He then gave me a prescription for NYSTATIN Ointment USP (100,000 Upg),to use twice daily till the infection goes away...And Low-& behold i think it left my Butt in less than 7-days..No more itchy-scratchy feeling...The red bumps dissapeared..That Red wring around my Butt went away and it no longer dries up....

You may want to inquire about NYSTATIN..But if you're currently on the road to recovery,then the oinment your Dr.-prescribed worked..

I'm NOT a Dr...But IT'S NOT HERPES!!!!
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