2 lesions on genitals

[yogi495]

I had sex with a prostitute. used a condom but was given oral sex without it for 1 minute. It was rough sex  I recall  her teeth were hurting my penis (with condom on) and at the end when she took out the condom I think I felt pain  
20 hours later I found an ulcer  about 2mm round , on the base of my shaft bleeding center  deep center as I saw dark red blood.  no borders just a round cut out area with center being deep. did not notice any other lesions I checked ever where. I was worried since I did not recall seeing the lesion right after sex when washing myself ruling out trauma, but I also thought its way too early for a std manifestation to occur hence ruling in truma, so I was not sure.  
48 hours later when examening the ulcer (it had closed up quite a bit but would still bleed If I stretched it) I found another lesion on my ball area same side. then I panicked I though this cannot be trauma anymore. this lesion had a tip that was also bloody  sitting on a raised red bolbous base. this one scabbed over within the same day but the original one on the shaft was still open.
it has been a week since the exposure the original ulcer is still there trying to close up (not scabing but just trying to get smaller and closing up on itself) but everytime I stretch it it gets bigger and bleeds again. the other one has a scabbed center/tip and bulbous red raised base around it.
1-Could my initial exam of my genitals after finding the first ulcer have caused a folliculitis, hence the second lesion?  I touched all around my scortum after touching the original ulcer.
2-Could this be viral like herpes? 3-why was the hiv testing ordered by urologist and isn't it way too early for detection anyway? and 4-can his guess of one being traumatic and the other folliculitis be correct? when should these go away?
by the way there is some itching when I urinate so that make me worried as well.

[Edward W Hook, MD]

Welcome to the Forum.  I'll try to help but sorting out what has gone on will be difficult as the lesions sound to now be well on their way to healing.  It is easier to say what they are not.  

The lesions you describe are unlikely to be STDs, both because they appeared so soon after exposure and because they are already healing. Whether they might have been the result of trauma plus perhaps folliculitis is possible but hard to be sure of.  let's deal with your specific questions:

1.  Doubt it.  Just as it is unusual to transfer STDs on one's hands to other parts of the body, it is also unusual to transfer other infections.  I suspect that you will not know what caused it.

2.  No.  Appearance is atypical, location is atypical and time course is atypical, amongst other things.

3.  I suspect the urologist was being thorough and hadn't thought through the time sequence carefully.

4.  Sure.  Coincidences occur.  Again, as I have said several times, STDs of any sort seem most unlikely.  EWH

[Edward W Hook, MD]

Herpes lesions do not form scabs- more evidence that this is unlikely to be HSV.  Herpes cultures can be taken from dry skin, blister fluid or from normal intact appearing skin.  Many doctors have the misconception that you must have a fresh ulcer or blister for culturing HSV- this is incorrect.   EWH

[yogi495]

I will be going to same urologist tomorrow to take a culture as you have advised. but is it too late if they have all become hard with scabs over them. 11 days after exposure these fluid filled blisters showed at the sight of second lesion they got bigger during the day they joined by the next day and burst and scabed over by the third day. I mean isnt this very typical of herpes blisters ? annd now I am left with a raised piece of skin about the size of a quarter, painful and with black scab dots all over it. can this be cultured? and what else besides HSV can this be? pleaaaaaaase doc give me one last annswer thanks. I know time line is off with HSV but the lesions and its pattern can't be anything else can it? pleeeeeeeeeeeeeeaaaaaaaaase answer one last time..thanks

[Edward W Hook, MD]

I really have nothing more to say.  If you think this is HSV, you should get tested for HSV with either a culture or PCR test taken using a swab from the lesions.  Either of these tests should provide you with an answer as to whether or not this is HSV, as well as what type of virus is present.  EWH

[yogi495]

doc sorry to bother again specially during christmas, but I think this is herpes, woke up today with vesicles where the second lesion was, fluid filled they were small but got bigger during the day fluid filled itching and slight burning its been 9 days since exposure, they are at scortum. very scared. can it be something else? differential diagnosis? I used protection. If I need t0 pay again for advise please let me know. can herpes occur at that area? by the base of shaft but on scortum? can it be type 1 or 2? there are 10-20 small vesicles getting bigger, please help.

[yogi495]

thanks doctor.
been on Levaquin (which has crazy side effects on its own , do not recommend it) first lesion is gone less than 10 days after seeing it, second is still around and now it looks like the first lesion but its also trying to heal. still very puzzled about what they could have been, but thanks for telling me what they probobly are not which helped me calm my nerves.
thanks again.

[yogi495]

Sorry, posted in wrong forum by accident but appreciate an answer .thanks