Today I saw a family practice physician who opined the "very angry" inflammation on my coronal sulcus was not herpes and contrary to every presentation of herpes she has ever seened, but she suggested taking the herpes test in any case. She thought the inflammation might be something like a yeast infection in the meantime and prescribed nystatin and triamcinolone acetonide ointment. I applied it eight hours ago and the inflammation is greatly reduced and there is no discomfort whatsoever.
Thank you, Doctor Kaur. My dermatologist could not make a diagnosis of herpes based on examination during active episode. He tested for syphlis which was negative. Since posting my original question, my online search has come up with a condition that sounds very much like mine because it appears at or after vigorous sexual activity: non-venereal sclerosing lymphangitis, described as a rare penile lesion consisting of a minimally tender, indurated cord involving the caronal sulcus and occasionally adjacent distal penile skin. The disorder most often occurs after vigorous sexual activity and resolves spontaneously. In my case a cord is not apparent however, just the raw ulcer sores on the coronal sulcus - they only appear during or after vigorous sexual activity, usually fellatio with a new partner is included in the activity, causing me to wonder if the new saliva has something to do with the reaction. It does not occur if the same partner repeats the activity after resolution ( several days to a week or two), unless a span of a month or more elapses before the next meeting with the same partner. Thus, episodes seem to occur only after abstinence of prolonged duration.
Hello,
From the symptoms the possibility of herpes needs to be ruled out. Genital herpes is a sexually transmitted disease (STD) caused by the herpes simplex viruses type 1 (HSV-1) and type 2 (HSV-2). Most individuals have no or only minimal signs or symptoms from HSV-1 or HSV-2 infection. When signs do occur, they typically appear as one or more blisters on or around the genitals or rectum. The blisters break, leaving tender ulcers (sores) that may take two to four weeks to heal the first time they occur. Typically, another outbreak can appear weeks or months after the first, but it almost always is less severe and shorter than the first outbreak.
The only way of ruling it out is by getting yourself tested for genital herpes. Laboratory tests include: culture of the virus, direct fluorescent antibody (DFA) studies to detect virus, skin biopsy, and polymerase chain reaction (PCR) to test for presence of viral DNA. I sincerely advise you to consult a dermatologist and get it ruled out.
It is very difficult to precisely confirm a diagnosis without examination and investigations and the answer is based on the medical information provided. For exact diagnosis, you are requested to consult your doctor. I sincerely hope that helps. Take care and please do keep me posted on how you are doing.