Groin/Penis Rash - Freaking Out

[jeremyst]

Doctor, thank you in advance. Nine weeks ago I had protected vaginal sex with a sex worker. About a week after I developed a red bumpy rash in the crease of my groin. It appeared that there were small red, pimples that itched and hurt. I went to my GP who said the rash in my groin didn’t resemble an std, and suggested lotrimin, which severely dried the area out. Difficult to tell how much it actually helped the rash. At 4 weeks I tested  negative on an IGG test for HSV1and2. The rash sort of gets better and then gets worse. Also, negative for HSV2 (igg) at 6 weeks as well

At the end of week 7 the head of my penis around the opening became red and irritated. My GP, again told me it wasn’t herpes, but sent me to a dermatologist. The dermatologist couldn’t identify the rash, but gave me desonide for the groin and the head of my penis. I felt that the rash got worse in the ensuing week – particularly on the head of the penis. I felt stinging, and occasional irritation in what feels like inside the penis.

I returned to the Dermatologist, who suggested I continue Desonide in the groin and a stronger cortical steroid on the head of my penis. The head hasn’t improved, and while the redness in the groin has gone away, there is a scattering of painful red bumps at the top of the crease of my groin (my right side). They look like small evenly spaced pimples. some with tiny white heads. If I pull on my pubic hair, I notice that they are all follicles.

My concerns: Is this an STD? I am married, made a terrible mistake, and want to move on with my life. My wife is pregnant, and I am absolutely freaking out to the point of paralysis. Is there a chance this is mildly symptomatic herpes? Really, it’s the pain of the bumps and the painful irritation on the head of the penis that worries me. Also – that my dermatologist can’t definitively diagnose. Would it make sense to get another HSV test at 10 weeks, or do I need to wait until 12 weeks? What’s going on with me?

[Alan Rockoff, MD]

Other than some irritation, some blocked pores, and a whole lot of guilt, I don't think much is going on with you at all.  Your dermatologist would have certainly been able to diagnose herpes if he or she saw it.  It doesn't sound like herpes at all, "mildly symptomatic" or otherwise.  You've seen a GP and a specialist, both of whom told you that you don't have an STD.  It's time to take them at their word, to leave the groin alone (no pulling on pubic hairs, for instance, to see if there's a follicle at the base.)  Just forget about it and let your body heal.  I see no reason for you to get another herpes antibody test.  I think the irritation at the head of the penis is just that--irritation, which should be addressed by using non-medicated moisturizer and avoidance of friction.  Continue to work with your dermatologist on this if you need more reassurance.

Best.

Dr. Rockoff

[jeremyst]

Quick additional comment - I understand that this is also an std forum issue - but wanted to ask you b/c of the dermatology connection - thanks so much for your help, and hopefully a bit of piece of mind.