Herpes?

[reed324]

About one month ago (June the 10th) I had sex with a young woman. I used protection but, unfortunately, it came off mid-coitus.
  Approx. two days later, I was in the bathroom felt an odd sensation in my genitals.  Nothing I would describe as a pain, burning, or tingling - it was more like a tickling feeling and it was localized solely on one specific area (on the upper left hand side of the head of my penis).  It also wasn't constant - it only became noticeable when that specific part of my genitals would rub against my clothing.  It intensified for four to five days, then abated but did not go away entirely - in fact, as of this morning, it's still causing me a mild amount of discomfort and pain.  
  During the same trip to the bathroom, I also noticed two red areas on the head and shaft of my penis.  I inspected them carefully and removed dead skin from both areas.  Although the areas appeared to be inflammed, neither one hurt, burned, itched, etc.
  Approx 1. week later, I began having mild abdominal pain.  Nothing serious, but definitely noticeable.  It would come and go, usually when I was sitting down, and seemed to alternate between a dull "tight" sort of pain and a short, piercing pain.  Around that time I also began experiencing off and on shooting pains through my genitals.  (The shooting pains in my genitals disappeared in about a week, but the abdominal pain has persisted.)    
At this point, I took a closer look at the inflamed areas on my penis and noticed that one of the areas displayed a cluster of red round papules.  None of them were raised above the skin and none of them have since gone to form blisters.  I did, however, discover at least five more papules over the next two weeks.  One by itself on the underside of my penile shaft, and two groups of two or three papules, considerably smaller than the others, on the topside of my penile shaft.  I can't be entirely sure they weren't always there but, as you can imagine, I was checking myself like crazy so it seems unlikely.  As of the writing of this message, all of these papules are still visible on my skin and have not healed or gone away.  (In fact, I'm beginning to wonder if they might not be spreading.)    
  Three weeks after my initial encounter I developed a painful lesion on the webing of my big toe.  The lesion was puss filled and made it painful to walk.  After a week, the lesion went red and I ceased to feel any pain.  I did, however, begin to experiencing pains in the backs of my legs.  Sometimes it felt like a pulled hamstring, other times like someone was grabbing my ankles.
  Since the onset of symptoms, I have seen two dermatologists.  The first dermatologist examined the papules and diagnosed herpes.  The second dermatologist performed a more thorough exam and concluded that, as the papules were painless and had not formed blisters, it was most likely an irritation.  She pres'd a steriod cream.  
  At this point I'm very confused; could this be herpes?

[Alan Rockoff, MD]

Just because your partner has the virus doesn't automatically mean that anything you get after being in contact is herpes.  You need to find out what you have.  That's the best explanation I can give.

Dr. Rockoff

[reed324]

Good Morning Doc,

A brief update & a quick question for you.

Firstly, the update: the steroid cream that my second derm. prescribed seems to be working well.  The papules that have been been visible on my genitals for the better of June and all of July have noticeably begun to heal / disappear.  Obviously, this is reassuring for me since my understanding is that if my papules were caused by herpes, the steroid cream would have only served to make things worse.  (Please correct me if that's wrong.)  I have a follow up appt. scheduled for the 26th and will raise the fact that my partner tested positive for HSV-2 and see what the derm. rec'ds from there.  Please let me know if you think there's anything in particular I should say or ask for as a patient.

Secondly, the question:  In your last response, you seemed to indicate that, although my partner tested positive for HSV-2, there was a chance that I might not have contracted the virus.  (As you'll recall from my initial post, I used a condom but it came off mid-coitus.)  Could you explain this a little better to me?  From what little I've read, there's a 70-80% chance of contracting herpes if you have unprotected sex even if they're not in the middle of an outbreak.  

Thanks!

[Alan Rockoff, MD]

These do not sound anything like herpes.  My advice remains the same, only more so.

Dr. Rockoff

[mmm19]

for a few months i have noticed a few red bumps on the bottom of the head of my penis.  I have not felt any discomfort or any other kind of symtoms usually classified with herpes. The only thing i can describe is that they are small redish/white bumps that have been there for a while.  THey have not gone away but they show no immediate threat.  they have started to spread around slowly, but it is not bad.  besides the fact that they are noticeable by looking at them, i would not be able to tell that they are present. could it be herpes? and could a herpes outbreak last that long? what else could it be and what should i do?

[Alan Rockoff, MD]

Possibly, but possibly not.  Either way, life will go on.  You will live to cook and eat many other geese.

Dr. Rockoff

[reed324]

Doc,

Thanks for your input.  Unfortunately, I heard from the young woman I alluded to in my message today, and she's tested positive for HSV-2.  I'll have to get a blood test to be absolutely positive but I think at this point my goose is cooked.

Again, thank you for your insight and prompt reply.

[Alan Rockoff, MD]

Doesn't sound like it.  I think you should wait a couple of months and have a herpes blood test, just to be able to set aside the first dermatologist's snap diagnosis.  I can't make much sense of the pains.  Unless they persist or recur, I'd forget about them.  I don't think the toe web problem is related.  You are examining yourself too often and too closely--this will not do you any good.  Whatever came that soon after your encounter came too soon to be herpes, at least contracted from that encounter.  Mostly, it sounds like anxiety and over-examination, followed by more anxiety.

Best.

Dr. Rockoff