Herpes type I on side of knee? Very confused and worried.

[Texas99]

I have had cold sores for many years, starting from a young age. I believe I have had herpetic whitlow on the back of my left thumb (as a child sucking my thumb) and some herpes sores on the tops of my fingers (do to perhaps rubbing my nose and being unaware I had cold sores in the tip of my nose). I have also had them on the outside corners of my mouth (mostly red sores no real blisters. I have had itching in my genital region only on my scrotum and crotch area,(mild to real itchy)I do believe I have sensitive skin and have had "soap" rashes on my hips and armpits were my clothes rub. I have never seen any blisters in my genital region.  I do know that I have had my scrotum skin sting while taking a shower (would not notice otherwise), have had a break in my scrotal skin between my scrotum and crotch portion of my leg (this resolved it self in 2 days, no itching, very small, but could feel it), but none of this has returned to the same location. My occasional itching does seem to be confined to only my scrotal skin.  I do remember having what I called "prickly heat" once on my scrotum as well, but after I went swimming it was gone that same day a few hours later. Mostly, if I thought I had something on my genitals (or scrotum) I somewhat assumed it was "jock itch" since I run and workout fairly regularly. Obviously, I have taken care to be vigilant in my observation of my skin due to the following reason which should make this clearer. The unusual part is that about 13 years ago I had a linear line of blisters (relatively small about 7mm long) on the left side of my right leg at the knee.When I slept, my legs touched together and it seemed to make a slight rash on the other leg.  It did itch intensely and I did not really notice any blisters until I looked extremely close and they were very small and deep in the skin, it was not painful, but did itch. The dermatome would be in the L4 region.  Three years later it appeared in the exact same spot; not as severe, and has not returned again,(this was 10 years ago).When it did return many years ago, I seemed to have a dull headache. I did go to my dermatologist, he did not culture the rash on my knee and I had no other lesions on my genitals, since he visually examined me. The dermatologist said this looked like herpes, not shingles.  He ruled out a fixed drug reaction or contact dermatitis due to my history. I had two type specific tests performed, "Herpes Select" and the U of W "Western Blot", each test indicated positive for HSV 1 and negative for HSV 2.Is this rash due to Genital Herpes? Are nerve paths normally connected from the genital region to the side of the knee? Did herpes innovate my skin in this this location or my genitals.Can shingles be mild and return in the same location (had chickenpoxs at 25).Is this something I should share with my partner, if I have a future relationship? I have never knowingly passed on herpes to any partner. I am not immune compromised(Neg. for AIDS). Thanks

[Alan Rockoff, MD]

Shingles does not recur in the same place.  Herpes simplex can, but a negative Herpes Select test for herpes 2 is very strong evidence that you don't have it.  Therefore, the linear blisters you describe on your thigh must have been something else, perhaps irritation.  This means that your extra vigilance is not necessary and that all these minor variations you're seeing don't mean much, and certainly don't mean herpes.  You're probably best ignoring them.  Please ask your dermatologist for confirmation of these impressions.  Overall, though, I'd say it's time to stop thinking about this and move on.

Best.

Dr. Rockoff