Herpes/hpv/Psoriasis?

So, to give you background, I initially posted a question for Dr. Hook in the std forum and you can see my medical history and his advice there at http://www.medhelp.org/posts/STDs/Red-spot/show/798250. I am posting here because my urologist no longer believes that it is an std and is sending me to a dermatologist and I wanted to get an opinion from a dermatologist now as I was not able to obtain an appointment for a couple of weeks.

Since the last posting on there, I have gone back to my urologist and he was still concerned.  He did not take additional blood work, but did take another UA which he said was clean.  He said that I had blisters at the meatus (I can't see them, but that whole area is painful as can be) and also was concerned about the fact that the red spots had not gone away (he referred to them as a ring around the glans (glands) penis, but I think they are more accurately described as being located around the sulcus).  There are still roughly 3-4 spots that seem to vary by time of day in how red they are and whether or not they are raised.  The urologist briefly mentioned psoriasis as a possibility, but I do not have marks elsewhere on my body and he did not mention any other possibilities.

to help prepare myself, do you have any ideas for what this could be?

[Alan Rockoff, MD]

I agree with Dr. Hook's opinion.  These do not sound like warts.  (Warts are not painful, among many other things.)  Warts are generally diagnosed by inspection alone.  If a test is needed, a  skin biopsy would be the best one, but may well not be necessary in your case.  The visit with the dermatologist should tell the tale.

Take care.

Dr. Rockoff

[calidebate]

Additionally, I will say that my primary concern at the moment is genital warts. I believe that my doctor said that he also ran a PCR test (believe he said these initials, he was going very fast when he reviewed my results) and that it was negative. After googling, I have discovered this might be a somewhat experimental test to run on a man.  Additional questions for you are: (1) would the PCR test show whether or not I had the HPV strains capable of causing warts? and  (2) is there a reliable test to be run in the presence of symptoms to determine if it is actually warts or do doctors rely completely on a visual inspection and their own judgment? (I ask because I had a number of doctors last year who misdiagnosed me with various maladies so I now prefer to have an actual test to prove something one way or another).

[calidebate]

sorry, last comment -- if he did run a PCR test, it would have been from my blood sample as he didn't take any swabs or samples of the area.

[calidebate]

Doctor,

Thank you for the response, but based on your comment about the pain, I believe there was a miscommunication.  There are two problems (1) the blisters at the meatus that are painful (2) the red spots around the sulcus which are not painful.  Does this change your impression at all?

Thank you!