What could have caused this skin lesion?

About two weeks ago I noticed a skin lesion on my arm. The lesion was located on the upper portion of my arm, just past the elbow and somewhat near the bicep area. It's on the outside of the arm (if I stood with my hands relaxed at my sides you would see it just above my elbow).

The lesion is about a cm in diameter and circular. When I first noticed it it was red and had four white bumps within it. I'm not sure if it appeared in that exact state or if there was some sort of progression, that is just how I noticed it at first. It did not itch and I did not see anything leaking or oozing from it. When I touched it it was dry.

I think it must have popped up relatively quickly since I played hockey the night before and would have seen it putting my elbow pads on, but that's just speculation. I have not noticed any other lesions in the area, or anywhere else on my body after heavy inspection.

I showed it to a doctore at a medi-center and he determined that it's likely viral, due to the fact that there was no itching at all associated with it, and the way it was healing after one week (consistant scab overall, not a ring or anything like that).

My primary concern is that this lesion might be herpetic. He felt pretty confident that that was not the case due to the location and appearance.

I've been trying to find more information as to what could cause a viral lesion on the arm and the only answer I can find is herpes. This has me very worried as I'm currently waiting to do a follow-up HSV blood test in about three (very long) months and I'm scared that it's going to come up positive because of this...

What do you think? Does this sound herpetic? Other than herpes what explanation could there be for this? I've never seen anything like this before on my body.

[Jasmina Jankicevic, MD, MSc, CCRP]

Welcome to the Dermatology Expert Forum!

Yes, it could be a herpes simplex infection. However, it is possible your skin came in contact with mild irritant or even allergenic substance that could have caused the lesion you described. There are several other skin diseases that can be manifested by type of lesions you described, but many do not resolve spontaneously. If you acquire more lesions, visit to a dermatologist is the best way to go.

In the meantime, stop worrying. Even if Herpes simplex virus is the cause, it is manageable.

Wishing You Optimal Health,
Dr Jasmina Jankicevic