Herpes? Warts? Molluscum? Argh!

I had sex with a girl and about a week later I noticed these 'pimples' on the base of my penis and very lower abdomen. There are a few on the underside of my shaft as well. My last sex before her was with my GF about 4 months previously.

They are a bit hard to the touch, and I've taken a very detailed photo with my digital camera and they seem to have a round pearly center. They are about the size of a grain of sand or two.

I've visited three docs and none know what it is. They did not use a colposcope and probably didn't see the amount of detail I've shown in this picture. I finally have a dermatologist appointment but that's a bit aways. Anyone care to weigh in?

Picture note: They look big here, but that's because they're blown up with my camera. They're abut the size of a grain of sand or two.

(altenative link) http://www.imageanon.com/static/ee3957a6341e9492a461d31ec799d78f.jpg


I don't know if this is a weird case of herpes (only considering it because the incubation period makes sense), warts, or molluscum.

[copado]

I had follicalitus which was a byproduct of MRSA.  I think MRSA is far more prevelant than the current infectious diseases centers are aware of.  culture one of the pustules for MRSA.   Mine lasted in recurring and disappearing cases for the last year and a half.  

[anon39]

Is that what it looks like? Hm..

[Vanessa Lacuesta]

Hi,

Are the bumps skin colored or are they reddish in appearance? I have seen the image and the size of the image could have altered the colors.

This appears to be clustered shiny bumps and they do appear to be hard to the touch. I do not think this is herpes. A viral cause may still be a likely differential. Molluscum presents with an umbilicated center and they usually are skin colored. I do not see any depressions or umbilications in the bumps.

For how long have you noted this? Has this been present for months? I suggest that you have blood tests taken for STD's nevertheless given a significant sexual history. At this point, you may continue to observe the symptoms if this is something of recent onset. The bumps may evolve in appearance which can aid better  diagnosis. You may discuss with your physician if a sample of a fluid from the blister may be used for analysis. However, in this case, the bumps do not appear to contain fluid.

Refrain from any sexual contact for the moment until this has been properly assessed. HSV infection may be assessed through blood tests .If the examinations are unremarkable and the bumps continue to exist you may ask your physician regarding the advantage of a skin biopsy for diagnosis.

[anon39]

Hi Vanessa,

They have been around for about a week and a half. I just got a bunch of std bloodwork done (except for herpes) and they all came back negative.The bumps are a bit redder at the base than you can see because of the flash.

If you look at the URL I provided in my original post you will see the picture with a lot more detail than the thumbnail. Also, a few of the bumps do have craters.

http://imageanon.com/static/11758205836e2644266faec344fde171.jpg

My guess is molluscum or bizzare herpes, but I read molluscum can take anywhere from 1 week to 6 months to manifest. All 3 diocs said herpes was unlikely, and guessed molluscum or maybe warts, but refused to give a diagnoses OR do a biopsy.


Thanks for your help,

[anon39]

To answer your first question, bumps are mostly light-than-skin colored (pearly white, light yellow). The area around the tips are lightly red.

[anon39]

bump

[Vanessa Lacuesta]

Hi,

Molluscum is a likely differential here. As I have mentioned, this does not really present with the typical or conventional appearance of the disease but the condition appears to be due to a viral cause. Bacterial infections are more painful, reddish, tender and may contain pus. The umbilications or depressions are unique characteristics of molluscum. If this is present ,then molluscum is highly probable.

Molluscum does present atypically .They may present as single large nodules or they may develop a stalk.

"Atypical lesions may resemble comedones, abscesses, furuncles, condylomas, syringomas, keratoacanthomas, basal cell carcinomas, ecthymas, sebaceous nevi of Jadassohn, and cutaneous horns . Importantly, disseminated fungal infections, specifically cryptococcosis, Penicillium marneffei infection and histoplasmosis, are reported to clinically mimic molluscum contagiosum and should be included in the differential diagnosis for these patients. "
Source:http://dermatology.cdlib.org/95/original/molluscum/thappa.html

The conditions mentioned above are not likely to be your case. I included this entry from a journal just to show that molluscum may present atypically and the person's immune response is a factor.

Just continue to observe your symptoms. In most cases, this skin condition may spontaneously resolve given that no overlying bacterial infection is present. Avoid touching the area. Abstain from sexual activity for the moment. You may ask your physician if a trial on molluscum treatment may help.