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My doctor said herpes, but how did I contract it?
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My doctor said herpes, but how did I contract it?

Hello, I am hoping you can clarify some things my doctor told me...

I am a healthy 23 yr old male with no health problems.

I've lived in Japan for the past year and in the beginning of December of 2008 I suddenly noticed a rash of ulcers along my left buttock.

They looked like this (link)

http://www.medicc.org/publications/medicc_review/V/1/images/herp7.jpg

But only on my left buttock in a small area.

The day after noticing this my entire left thigh was swollen.  I took Avelox once a day for 3 days and that helped.  This was the only medication I took.

The rash was very uncomfortable before I got a bandage to cover it and moderately itchy.  But it was very easy for me to ignore it.  

I was able to have it checked by my American doctor later.  It had scabbed over and she determined it was HSV-2 and gave Valtrex.  I went for a second opinion with a doctor and he determined it was shingles.

He said because it was my FIRST outbreak and on my buttock it was uncommon to genital herpes.

I had received a bloodtest for herpes antibodies that came negative, but my first doctor said be would be inaccurate so soon.  In my entire life I have had sexual activity with only 3 women, ALL OF WHOM TEST NEGATIVE FOR HERPES.

Since I had two competing theories from doctors I decided to see a dermatologist but had to in Japan.  My problem is that I don't understand what he told me.

He told me he believed it was Herpes Simplex 2.  But since it was on my buttocks it was not an STD?, and probably came due to stress?  I made sure he understood this was my first outbreak but he said there is a long incubation period.  He said it may be from my parents, neither of whom have HSV-2 but both have HSV-1.

He said I am only contagious when there is a fresh ulcer. There are no accurate tests?  How did I contract it?

This is how it looks now (link, this is my picture)

http://img353.imageshack.us/img353/7684/img1656bm2.jpg
http://img135.imageshack.us/img135/5498/img1655os1.jpg

Plz help
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The first picture you showed me (not your skin) is shingles.  This is caused by a virus in the herpes family but is not genital herpes simplex.  Your case sounds like genital herpes simplex, or is at least compatible with it.  There is, however, a chance it was shingles that was more localized than usual.  Genital herpes can appear up front (on the penis) or on the back, where you show your rash was.  The best test to tell is a type-specific herpes IgG test for type 2 herpes.  If you had one that was negative, you should have it repeated in 2 months.  If it's negative again, that would argue against genital herpes and possibly in favor a shingles that was localized to one spot.  If you get another outbreak in the same spot, that would prove it is genital herpes simplex.  If it does turn out to be genital herpes simplex, that would presumably mean that the herpes tests one of your sexual contacts had weren't as negative as they thought.  Meantime, check with your doctor who did your herpes simplex tests to see what kind of test it was, and possibly to arrange to have it repeated.

Best.

Dr. Rockoff
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