Gay Male with Anal Herpes with Anal Psoriasis- Seeks Better Treatment Protocol

[brightlight779]

I am a 30 year old gay HIV-negative male with anal herpes and anal psoriasis; two conditions which seem to provoke each other.  As well, I had a severe case of anal warts (internal and external) 5 years ago. I have tested negative for all other STDs.

*Anal Herpes: internal and external, with mild attacks every 2 months for the last 5 years.  They take the form of razor-thin cuts, rather than blisters.  I am currently on Valtrex 500mg/day.

*Psoriasis: extends from the scrotum to the anus.  Have used Elocom (mometasone) when I start peeling (applied for two days every 1-2 months).

*Anal Warts: Internal and external.  Appeared 5 years ago, and no longer symptomatic.  However, I was treated by many multiple electro-cauteries (burning) and freezing.  I suspect that the many treatments would have left my anal skin much more fragile.

It seems that the scratching from the psoriasis provokes the herpes.  Because the herpes appears as tiny razor thin cuts instead of blisters, I have a hard time distinguishing between the psoriasis and the herpes (both are itchy).  The only time I can really tell is when I experience burning inside my rectum- which suggests herpes.

I am looking for a treatment that will:

a) treat my ano-genital psoriasis without thinning the skin (Protopic was suggested.)
b) strengthen and thicken my anal skin- this is important because I am having problems having anal sex.
c) treat the anal herpes

[jagesh50]

Have you got the leisions biopsied?Bowens disease is known to occur in homosexual men and eminently treatable.If you have been biopsied this diagnosis is superfluous,if not worth having to look in.

[brightlight779]

I have no reason to think it is Bowen's disease. According to Wikipedia, Bowen's disease presents as gradually enlarging, well demarcated erythematous plaque with an irregular border and surface crusting or scaling.  I do not have this plaque, and my scaling disappears with application of Elocom.  Psoriasis also runs in my family, so my current diagnosis is plausible.

Can anyone here answer my question?

[jagesh50]

The fact that it disappears after elocon will indeed be against the diagnosis of bowens.

[reik2424]

? hi i fill a bump in the inside of my anal part i dont know if it a wart but in the internal part if fills like a skin tag

[tonkatough79]

Can someone please help me, too? I am a 30 year old, gay HIV negative - free of all STDs man that is suffering from the same symptoms above, although I am not suffering from warts. Horrible anal flare-ups, bleeding, redness, cracking etc. I've been getting injections from a dermatologists in this area (believe it or not) to calm the flare-ups. I'm using a hydrocortozone, too. The redness/soreness may go away for two or three days, then all symptoms return. I'm desperate for help.
I've used the protopics, elocon, etc. No results. I have a closet full of creams/ointments. Nothing seems to work. Could it be something else?

[brightlight779]

You have the same symptoms or you have the actual diagnosis for anal psoriasis/herpes?
Do you scratch the area regularly?  Scratching or anal sex will easily cause trauma to the delicate anal skin, which will in turn provoke herpes attacks--so you have to everything in your power to avoid scratching.  The best solution I've found was hemorrhoid preparations with mint- the burning of the mint stops the itching.

Your situation is more complicated than mine- simply because yours comes back 2-3 days after treatment.  The worst thing you can do right now is to continually administer steroid creams to the region because it will keep on thinning your skin- sometimes permanently.  If the skin keeps gets thinner, then you can kiss any chance of anal sex goodbye.  I have been applying Elocom 1-2 days every month for 10 years and now everytime I have anal sex, I tear a little bit and it takes me 2 weeks to recover.

The best thing you can do is try the non-steroid treatments.  I tried Protopic (stops immune response) but since it stops immune response, it triggered herpes attacks- even when I was taking Valtrex every day!  You should try it and give it a few weeks to start working-- it may work for you.  You have many other choices but with more risks- like other creams, UV therapy, and others.  If I were in your shoes, I'd probably seek to avoid steroid creams/injections at all costs but only if you need to apply them every 2nd day.

I've come up with a kind of compromise treatment protocol.  The Valtrex I take every day greatly reduces herpes flareups.  Whenever I get psoriasis, I use Elocom.  Furthermore, I always use an anal douche and also shower after using the toilet to keep sparkling clean from the inside and out- so that there is little irritation.

I'm not sure where you live or which doctor you've been seeing, but I have a few suggestions.  Forget about doctors in private practice and make an appointment with a known expert at a dermatology clinic at a good hospital.  Large hospitals usually attract the best and brightest minds who will have different ideas and more up-to-date knowledge about new treatment modalities.

[tonkatough79]

Hi - and thanks for your post. I have tried endless amounts of creams/steroids, etc for such a long time around my anus and, while they will work for a short period of time, the flare ups will return. I've changed diet, etc and didn't see any results. My dermatologist has started injecting the area about once every two months to minimize flare ups because it has gotten so bad. When I applied Protopic to the area I jumped through the ceiling. It burnt so bad. I was instructed to stop using it. I didn't see any results after repetative use of Elocon.
I'm still confused on what to do. Not easy being a young gay man that has this type of issue. Anal sex will trigger problems, no doubt. But, I can't get relief long enough to even have sex. Quite embarrassing.
We can send a man to the moon but can get a cure for flare-ups? Frustrating.