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Dermatology  (Expert Forum)
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Possible genital herpes?
Answered by
Alan Rockoff, MD - dermatology, Child Skin Problems
The Rockoff Dermatology Center Brookline - MA
This forum is for questions regarding Dermatology issues, such as: skin rashes, acne, birthmarks, skin infections, rosacea, and general skin care.

Possible genital herpes?

by missunderstood, Aug 26, 2002 12:00AM
I'm writing about my husband.  We have been sexually active for nearly four years.  About 2 weeks ago, I noticed he had a tiny "rough" spot appox 1" below the head of his penis on the underside of the shaft.  When I looked more closely, the area looked just slightly dry/crusty but rather insignificant.  It was about 3-4mm in diameter.  There were no other lesions and it was gone the next day, leaving no scar or other remarkable remnant.  About a week later, I noticed a very slight swelling and redness just adjacent to the opening of his urethra.  The closest word I could use to describe it is "blister" but this is too strong, as again it was mild in size and form and seemed under the dermis.  Three days later, there was no hint of that lesion but a singular mild "dry" spot identical to the first one appeared about 1 cm to the left of the first location on the underside of the penile shaft.
As I have not seen his genitals every day, I do not know of the exact progression of the condition.  He got defensive and thought I was overreacting, and said he had noticed no symptoms whatsoever(pain, itch, burning, etc).
I don't want to jump to conclusions or overreact, but my vaginal discharge MAY be darker than usual.  Except for some brief discomfort yesterday, I have experienced no abdominal pain, leg pain, or lesions myself.  I have, however, had a problem with a chronic strep throat this year and I have been on several courses of antibiotics.  Could this in any way be related?  We had been living in a hot and humid climate.  We practice oral, and rarely anal sexual intercourse as well as sexual intercourse.  I have never before noticed any unusual lesions on our genitals, and we have no history of STDs so far as I know.   If it is herpes, what are the chances it's just recrudescing from a previous infection based on the timeline, or does this sound like a new infection?
I am worried about his health and mine.  Unfortunately, he thinks I'm trying to embarrass and pester him!  Thanks so much for your help, and I look forward to your reply.

by Alan Rockoff, MD, Aug 26, 2002 12:00AM
You say that the first thing you saw " . . . was gone the next day, leaving no scar or other remarkable remnant."  Herpes scabs for 7-10 days.  Vaginal herpes causes sores, not darker discharges.  Srep infections have nothing to do with herpes.

I think you need a good, thorough consultation, accompanied by pictures and education.  Otherwise, you run the risk of driving an unnecessary wedge between yourself and your husband.

For both your sakes, please find out to your satisfaction that you're OK, so you both can get on with your lives, sexual and otherwise.

Best.

Dr. Rockoff
Member Comments (3)

by missunderstood, Aug 27, 2002 12:00AM
To: Dr. Rockoff
Dr. Rockoff,
Thanks for your prompt reply.  I guess I wasn't terribly clear.  I meant to ask if there are any bacterial (strep or other) infections that could possibly produce the lesions/symptoms I described in lieu of herpes.  I realize that herpes is a viral infection and not related.  As I was once told by a nurse that oral sex could cause strep throat rarely, I wondered if that bacteria or could infect the genital area of some individuals, or even be considered normal flora?  
In addition, as I mentioned in my question, I have observed his penis only sporadically in the last three weeks, so I do not know the progression of the lesions or the course of time that they were present.  But herpes sounds unlikely in any case I gather.  
Looks like I was misunderstood again!
--MissUnderstood

by Alan Rockoff, MD, Aug 29, 2002 12:00AM
It doesn't sound like a bacterial infection either.  As for strep throat from oral sex, I don't think that's likely at all.

Take care.

Dr. Rockoff
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