Spots of redness on scrotum

About two weeks ago I noticed a spot of redness on my scrotum. It was not too big, maybe about the size of the eraser head. A week later I noticed two smaller spots a little lower. My first thought was herpes or some other STD. There was no fluid filled bumps which is the standard syhmprom of herpes. The skin was red and it appeared to have a small indentation or fissure in it (triangular shaped if that makes a difference).  I applied neosporin for a few days hoping it would go away but it did not. It does not really hurt at all except when I touched or rubbed it. Hydrogen Peroxide turned the spots white.

I went to the dermatologist. He did not discount herpes but said it would be atypical if it was herpes. He felt it might be skin irritation caused by a zipper, underwear or even sex. Nothing recently that happened to me would have caused such a trauma.

He perscribed Fluocinonide three times a day. Its been three weeks now and while it hasn't gotten any worse it hasn't really gotten much better. The redness is still there in all three spots but the skin seems a little more healed. Hydrogen peroxide didn't turn it white. But it still concerns me.

I've read that steroids, like Fluocinonide, irritates herpes. If it is indeed herpes and I used Fluocinonide what should I expect? How long does Fluocinonide typically take before results are seen?

[Alan Rockoff, MD]

Herpes wouldn't last three weeks, so the course favors zipper trauma or some such.  I'd stop the fluocinonide, since steroids can perpetuate redness.  I'd also call back the dermatologist and ask what to do next.  If he has some concern about herpes, he might want to suggest follow-up examination, blood testing, and so forth.  But overall, I think this will most likely turn out to be inflammation from minor trauma that will take care of itself over time if left alone.

Best.

Dr. Rockoff

[scrtlv]

I am going for another visit to the doctor today. The 2 larger spots have healed from the Fluocinonide I suppose and seem to have some scaring to them as they are still there. The smallest one is still there and it appears to have company. There is a rash that looks like several of the small spots near where the two newer spots appeared. The Fluocinonide started burning a bit yesterday when I applied it there and today, the spots are there. These hurt a bit more than the previous spots do when I touch them. I am off to the doc today. I do not know if it is herpes or not, but the lack of fluid filled heads on these spots means its not right?

Is there anything I should ask the doctor to administer? A specific test perhaps? A reccomendation of a creme or pill? I only say this as the Fluocinonide did not get rid of it.

[Alan Rockoff, MD]

Nothing special--an exam should do it.  Dr. Rockoff