Herpes for sure?

[Persevere]

I have a question that I'm worrying over that maybe those here can answer.

About a month ago I developed this tight cluster of pimples on my left buttock.  They literally appeared overnight.  For about 3 days they spread outward then stopped.  Initially, it was a bit numb but the next day my entire left thigh was swollen and painful to touch.  This was the only time they were painful.  I took some medication for infections and this put down the swelling in my thigh and the pimples stopped spreading.  The pimples were slightly painful if I rubbed them and slightly itchy some of the time.  I could ignore them pretty much all of the time.  During this period I developed a slight cold but could still go to work and was not bedridden at all.  About a week after they appeared I got a bandage to cover it and forgot about them (I was not aware of the symptoms of herpes at the time).  

About a week ago they began scabbing over on their own and falling off.  I also developed a single cold sore on the inside of my bottom lip that was far more painful than the pimples ever were.  It was exacerbated a great deal by my crooked teeth and eating over the holidays.

My doctor had a look and believes it to be herpes just from observation.  She did not know if it was type 1 or 2 and was of the opinion it did not matter.  She did not take a culture swab but I got a blood test that I haven't had the results for yet.  However, she tells me that blood tests aren't very accurate determinants.  She didn't seem confident of her diagnosis since she had to reference several books about herpes to tell me about it, and only determined I had herpes by examination although she said she is 100% sure.

I've had sex with two women over the period I could have contracted herpes, both of whom tell me they've had sex with no other men and were tested negative for STD's in early December.  This is why I'm wondering if it really is herpes or something else...

Is there any other illness that causes these symptoms but isn't herpes?  Could I somehow have contracted herpes non-sexually?  No one I know has herpes and I don't share personal items with others.  I just don't see how neither of them could have herpes and yet I do somehow...  There are still clusters of red spots where they were but there are no more white tipped pimples and no more scabs.  I'm afraid the tests will come back negative and I'll really have no idea if I have herpes or not.  If I see a dermatoligist soon, would I be able to find out for certain if I have herpes or something else?

[Bhupinder Kaur, MD]

Hello,

I cannot confirm anything without examination but the symptoms are definitely suggestive of herpes.How ever it can be as simple as boils or carbuncle also.The only method of confirming is by the tests.

Genital herpes is a sexually transmitted disease (STD) caused by the herpes simplex viruses type 1 (HSV-1) and type 2 (HSV-2). Most individuals have no or only minimal signs or symptoms from HSV-1 or HSV-2 infection. When signs do occur, they typically appear as one or more blisters on or around the genitals or rectum. The blisters break, leaving tender ulcers (sores) that may take two to four weeks to heal the first time they occur.

Herpes also presents with red itchy blisters which scab over. Herpes simplex is most easily transmitted by direct contact with a lesion or the body fluid of an infected individual. Transmission may also occur through skin-to-skin contact during periods of asymptomatic shedding.

The only way of ruling it out is by getting yourself tested for genital herpes. Laboratory tests include: culture of the virus, direct fluorescent antibody (DFA) studies to detect virus, skin biopsy, and polymerase chain reaction (PCR) to test for presence of viral DNA. I sincerely advise you to consult a dermatologist and get it ruled out.

Hope it helps. Take care and pls do keep me posted on how you are doing or if you have any additional queries.

[Persevere]

So I am very confused...

My doctor is of the firm belief that I have Herpes simplex.

I got a blood test that came out negative for HSV-1 AND HSV-2 antibodies...  But my doctor prepared me for that by saying the tests are very inaccurate.

Since I wanted to be sure, I went to a walk-in clinic to get a second opinion.  The doctor there then told me he was 100% sure I DID NOT have herpes simplex.  That I had herpes zoster (shingles).  He said this because of how mild my initial outbreak was, the manner in which my sores were healing, and most important to him was the location of the outbreak.

I am a very healthy male in my early 20's.  He says that an outbreak of herpes simplex on a person such as me that is NOT on the genital region (my outbreak was on my left buttock) is nearly unheard of.  He told me herpes simplex outbreaks like that would only occur in immunocompromised patients.  Patients with AIDS or HIV would have that, but not someone like me.  He also told me he had shingles and the symptoms are the same.  He also described the process of my symptoms dead on and showed me pictures of herpes zoster that looked exactly like my case.

Both my doctors believe the other is uninformed/mistaken/misunderstood and stand by their positions.

I've only slept with 2 girls in the past 6 months and both tell me that they were tested negative recently for STDs.  

It feels like the second doctor's diagnosis makes more sense for my situation.  But my doctor's convinced of her diagnosis.

Can anyone give me advice?  Should I consult a dermatologist?