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Dermatology (Expert Forum)
Oral herpes, Fordyce's condition, or herpangina etc.??
Answered by
Alan Rockoff, MD - dermatology, Child Skin Problems
The Rockoff Dermatology Center
Brookline - MA
Welcome to the DERMATOLOGY FORUM! Questions in this forum are answered by Dermatologists from St. Luke's Roosevelt Hospital, under the direction of Andrew Alexis, M.D., M.P.H.
Oral herpes, Fordyce's condition, or herpangina etc.??
by W87H, Jun 10, 2006 12:00AM
***This might be a question for STD forum, but my question #3 is probably best answered by a dermatologist***
About 9-10 days after giving unprotected cunnilingus and receiving unprotected oral and heavy kissing to someone of unknown sexual history and approximately 3-4 weeks after having unprotected sex with someone who has herpes (but wasn't suffering an outbreak), I noticed the following symptoms: swollen and painful neck glands (9th and 10th days only...much less swollen now), dry mouth and skin around the mouth, and lots of very tiny white dots on the inside of my lip and near the corners of my mouth. There are about 40-50 of these tiny white bumps and nearly all of them appear to be below the surface of the skin. In fact, now that I am about 6 days into having these symptoms (and 2+ weeks post-exposure), I see only a couple that appear like a very tiny raised blisters. Other symptoms incluse being generally tired and sore throat. I have recently begun to expel some darker mucous via mouth in the a.m. I occasonally cough or sneeze, but very rarely.
When I first noticed these symptoms, I had severe anxiety and panic and started looking for pictures of my white dots on the internet. In addition, I went to a local STD clinic and had comprehensive testing. All results were negative, but I await the HSV results. The doctor looked at my white bumps and throat and said he didn't see anything to suggest herpes at all. Also, I have not seen anything abnormal on my penis.
My questions are:
1. From my symptoms and given the fact that my white dots and bumps haven't turned larger, red, or yellow, or burst and crusted open, does this sound like oral herpes to you?
2. If it is oral HSV, could it be that I have had it and this is an outbreak induced by anxiety and stress? I have seen stats that suggest roughly 75% of the US population has oral HSV antibodies suggesting they were infected at some time.
3. Are there any reliable ways to distinguish small white dots and bumps caused by oral herpes vs. Fordyce's condition vs. herpangina?
4. Any other condition -or- combination of conditions that might be causing these symptoms?
5. I am checking my mouth and penis 4-5 times per day looking for noticeable changes. Any thought on duration of symptoms or by when I should expect to see larger red sores (assuming I have oral herpes)?
I am expecting that I have oral herpes, but haven't yet noticed any large red sores and, given my exposure, I am surprised that my penis appears completely normal.
I am watching my symptoms closely and am trying to get an appointment with a dermatologist and my PCP, but, until then, am interested to hear your feedback on my symptoms and/or recommendations.
Thank you in advance for your response.
About 9-10 days after giving unprotected cunnilingus and receiving unprotected oral and heavy kissing to someone of unknown sexual history and approximately 3-4 weeks after having unprotected sex with someone who has herpes (but wasn't suffering an outbreak), I noticed the following symptoms: swollen and painful neck glands (9th and 10th days only...much less swollen now), dry mouth and skin around the mouth, and lots of very tiny white dots on the inside of my lip and near the corners of my mouth. There are about 40-50 of these tiny white bumps and nearly all of them appear to be below the surface of the skin. In fact, now that I am about 6 days into having these symptoms (and 2+ weeks post-exposure), I see only a couple that appear like a very tiny raised blisters. Other symptoms incluse being generally tired and sore throat. I have recently begun to expel some darker mucous via mouth in the a.m. I occasonally cough or sneeze, but very rarely.
When I first noticed these symptoms, I had severe anxiety and panic and started looking for pictures of my white dots on the internet. In addition, I went to a local STD clinic and had comprehensive testing. All results were negative, but I await the HSV results. The doctor looked at my white bumps and throat and said he didn't see anything to suggest herpes at all. Also, I have not seen anything abnormal on my penis.
My questions are:
1. From my symptoms and given the fact that my white dots and bumps haven't turned larger, red, or yellow, or burst and crusted open, does this sound like oral herpes to you?
2. If it is oral HSV, could it be that I have had it and this is an outbreak induced by anxiety and stress? I have seen stats that suggest roughly 75% of the US population has oral HSV antibodies suggesting they were infected at some time.
3. Are there any reliable ways to distinguish small white dots and bumps caused by oral herpes vs. Fordyce's condition vs. herpangina?
4. Any other condition -or- combination of conditions that might be causing these symptoms?
5. I am checking my mouth and penis 4-5 times per day looking for noticeable changes. Any thought on duration of symptoms or by when I should expect to see larger red sores (assuming I have oral herpes)?
I am expecting that I have oral herpes, but haven't yet noticed any large red sores and, given my exposure, I am surprised that my penis appears completely normal.
I am watching my symptoms closely and am trying to get an appointment with a dermatologist and my PCP, but, until then, am interested to hear your feedback on my symptoms and/or recommendations.
Thank you in advance for your response.
Doctor's Answer
by Alan Rockoff, MD, Jun 11, 2006 12:00AM
, Jun 11, 2006 12:00AM
1. From my symptoms and given the fact that my white dots and bumps haven't turned larger, red, or yellow, or burst and crusted open, does this sound like oral herpes to you?
No, it sounds like Fordyce's condition, which you are noticing because you are afraid you have herpes.
2. If it is oral HSV, could it be that I have had it and this is an outbreak induced by anxiety and stress? I have seen stats that suggest roughly 75% of the US population has oral HSV antibodies suggesting they were infected at some time.
I doubt it.
3. Are there any reliable ways to distinguish small white dots and bumps caused by oral herpes vs. Fordyce's condition vs. herpangina?
Yes. Herpes causes blisters that scab and go away, not little white dots that don;t do either.
4. Any other condition -or- combination of conditions that might be causing these symptoms?
Fordyce's condition plus a viral upper respiratory infection.
5. I am checking my mouth and penis 4-5 times per day looking for noticeable changes. Any thought on duration of symptoms or by when I should expect to see larger red sores (assuming I have oral herpes)?
I suggest you keep your appointment and stop repeated checking.
Take care.
Dr. Rockoff
No, it sounds like Fordyce's condition, which you are noticing because you are afraid you have herpes.
2. If it is oral HSV, could it be that I have had it and this is an outbreak induced by anxiety and stress? I have seen stats that suggest roughly 75% of the US population has oral HSV antibodies suggesting they were infected at some time.
I doubt it.
3. Are there any reliable ways to distinguish small white dots and bumps caused by oral herpes vs. Fordyce's condition vs. herpangina?
Yes. Herpes causes blisters that scab and go away, not little white dots that don;t do either.
4. Any other condition -or- combination of conditions that might be causing these symptoms?
Fordyce's condition plus a viral upper respiratory infection.
5. I am checking my mouth and penis 4-5 times per day looking for noticeable changes. Any thought on duration of symptoms or by when I should expect to see larger red sores (assuming I have oral herpes)?
I suggest you keep your appointment and stop repeated checking.
Take care.
Dr. Rockoff
Can Fordyce's condition suddenly occur in conjunction with conditions - such as a possible respitory infection? Or can the condition just develop on it's own?
I ask because I noticed small bumps before, but never in the quantity and proliferation in which they now appear.
Thanks, Dr.
Dr. Rockoff