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Dermatology (Expert Forum)
What's the Diagnosis? (if any?)
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.
What's the Diagnosis? (if any?)
by daddyoh, Dec 01, 2004 12:00AM
For the last 4-6? weeks, I have been having 'problems' in the genital area, as I will describe. I have had days with no symptoms, but more days than not have been bothersome.
For a large part of the day, I have a dull ache involving my Left Testicle, with occasional 'tingling' involving the left side of my penis.
At times, this has been associated with 'bumps', almost always on the left side of the glans, looking either like small pimples-reddish..or like small whiteheads...They do not look like herpetic lesions. As this was my primary concern, however, I have seen my GP (very experienced) and a Men's Sex Health Clinic (obv. experienced) during these bumps...both of whom confidently stated this is not herpes...GP saying bumps are non-specific, Clinic saying (different time) looked maybe bacterial,fungal>prescribed Fucidin. The GP also didn't have an answer for the testicle pain. Exam normal.
What else...I have had pain in the testicle with no bumps and also vice versa.
I initially had the painful testicle and insignifcant bumps on glans MONTHS ago...got a requisition for an u-sound...but didn't get it done as pain/bumps resolved on their own...
Over this recent period, at times I have had itchiness...the other night i woke up in the early hours with my scrotum & glans very itchy.
On another occasion, my glans was covered with 'smegma'...that was difficult to come off.
Also, had a scrotal U/S (still had the requisition): Normal.
Sex Practice: Hetero with girlfriend. On Vacation in Feb, three protected intercourses + unprotected oral. Certainly no immediate problems after that. Uncircumcised. I am physically active.
So, multiple reassurances by doc (no herpes) and normal u/s..however, pain in L testicle (3/10 severity) continues i.e. right now...plus, occasional little bumps that come and go on left side of glans penis-not directly painful themselves.
THIS IS ANNOYING DUE TO THE SYMPTOMS AND ALSO WHAT IS GOING ON...STILL FEAR OF HSV-2. DOES MY STORY MAKE YOU THINK OF PARTICULAR DIAGNOSES...ANY FURTHER INVESTIGATIONS YOU RECOMMEND?
and now that I'm permanently paranoid of std's in the future...suppose Condom + no obvious lesions on female partner...what % chance do you think there is of getting hsv (from asymptomatic shedding) ??
For a large part of the day, I have a dull ache involving my Left Testicle, with occasional 'tingling' involving the left side of my penis.
At times, this has been associated with 'bumps', almost always on the left side of the glans, looking either like small pimples-reddish..or like small whiteheads...They do not look like herpetic lesions. As this was my primary concern, however, I have seen my GP (very experienced) and a Men's Sex Health Clinic (obv. experienced) during these bumps...both of whom confidently stated this is not herpes...GP saying bumps are non-specific, Clinic saying (different time) looked maybe bacterial,fungal>prescribed Fucidin. The GP also didn't have an answer for the testicle pain. Exam normal.
What else...I have had pain in the testicle with no bumps and also vice versa.
I initially had the painful testicle and insignifcant bumps on glans MONTHS ago...got a requisition for an u-sound...but didn't get it done as pain/bumps resolved on their own...
Over this recent period, at times I have had itchiness...the other night i woke up in the early hours with my scrotum & glans very itchy.
On another occasion, my glans was covered with 'smegma'...that was difficult to come off.
Also, had a scrotal U/S (still had the requisition): Normal.
Sex Practice: Hetero with girlfriend. On Vacation in Feb, three protected intercourses + unprotected oral. Certainly no immediate problems after that. Uncircumcised. I am physically active.
So, multiple reassurances by doc (no herpes) and normal u/s..however, pain in L testicle (3/10 severity) continues i.e. right now...plus, occasional little bumps that come and go on left side of glans penis-not directly painful themselves.
THIS IS ANNOYING DUE TO THE SYMPTOMS AND ALSO WHAT IS GOING ON...STILL FEAR OF HSV-2. DOES MY STORY MAKE YOU THINK OF PARTICULAR DIAGNOSES...ANY FURTHER INVESTIGATIONS YOU RECOMMEND?
and now that I'm permanently paranoid of std's in the future...suppose Condom + no obvious lesions on female partner...what % chance do you think there is of getting hsv (from asymptomatic shedding) ??
Doctor's Answer
by Alan Rockoff, MD, Dec 01, 2004 12:00AM
, Dec 01, 2004 12:00AM
Why do you still worry about herpes? How much reassurance will it take to get this obviously inappropriate diagnosis off your mind? My advice is to get a type-specific herpes 2 antibody test. When you find out it's negative, please take yes for an answer and move on.
I don't know why your testicle hurts. Maybe it's because you're worried about herpes. A urologist would best be able to exclude all other diagnoses.
I do not recommend any further investigations, beyond the herpes test I talked about, and even that is just for reassurance.
Condoms are helpful at protecting against herpes. That, plus being sure your partner doesn't have it is all you can do.
Best.
Dr. Rockoff
I don't know why your testicle hurts. Maybe it's because you're worried about herpes. A urologist would best be able to exclude all other diagnoses.
I do not recommend any further investigations, beyond the herpes test I talked about, and even that is just for reassurance.
Condoms are helpful at protecting against herpes. That, plus being sure your partner doesn't have it is all you can do.
Best.
Dr. Rockoff
Member Comments (3)
by 116021, Feb 22, 2005 12:00AM
i am wondering if i have testicular cancer. because i just started getting little pains in my left testicle but found no bumps or any thing like that. i do have a very small bump on my right testicle but does not hurt at all. i've been having these pains for about 3 days know and hoping it's not cancer can you help me is it testicular cancer and should i get this checked out? thanks.
by 116021, Feb 22, 2005 12:00AM
i am wondering if i have testicular cancer. because i just started getting little pains in my left testicle but found no bumps or any thing like that. i do have a very small bump on my right testicle but does not hurt at all. i've been having these pains for about 3 days know and hoping it's not cancer can you help me is it testicular cancer and should i get this checked out? thanks.
