Pregnant-Proper test for arms and hands

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BACKGROUND *** Althought I used condoms,I was diagnosed with genital herpes (located near anus) 17yrs ago.  It spread to vaginal area about 8years ago.  After the inital vaginal OB 8yrs ago, I've never seen a vaginal OB.  However - I've had discharge and internal itching through the years prior to OB's so I'm guessing it could be on my cervix?  I have no clue.  Both times I was diagnosed with a culture and visual exam.  I've never had a blood test.  I starting using an herbalist via e-mail and over the phone 5yrs ago.  His natural remedies seemed to make a difference since Valtrex had stopped working to stop, what appeared to be, new OB's on my arms and legs which look like mosquito bites.  I had sent the herbalist pictures and he confirmed the outbreaks were herpes based on appearance, symptoms and triggers, (alcohol, chocolate, stress).

I no longer work with the herbalist, I'm pregnant, and concerned about transferring HSV2 to the baby after birth while taking care of the baby, through touch.  I had an OB on both arms Sunday so I started Valtrex for 5 days.  It's already nearly gone after two days.  I'll also start Valtrex twice a day after 30weeks until after delivery.  Once a day indefinitely if OB's continue.

My OBGYN said herpes on arms and hands is RARE so I want to get an EXACT diagnosis so I'm clear on what I'm dealing with.  I'm not sure she's that familiar with herpes as most doctors don't seem to be.  QUESTION*** where is the BEST place for me to get an accurate diagnonis in Miami FL (or surrounding area)?  I made an appointment with a dermatoligist for this week but the bumps on arm will probably be completely gone by then anyway.  I want EXPERIENCED professionals who can give me complete testing; blood, culture, etc..who are also well educated about herpes.  What type of blood test?  When is best time for culture?  Please let me know.

Thanks for your help!

[loz23]

Hi. I just want to say I get herpes on my upper left arm, above my right knee and sometimes the left and also on my thigh sometimes. Only had 1 blister on labia 7 years ago. Apparently it is less contagious in these areas because they are "dry" ... that's what my doctor said. But avoid any contact while an outbreak is present... but when there isnt an outbreak the skin is too think to virally shed...

[Terri Warren, RN, Adult Nurse Practitioner]

Yes, do let me know.


Terri

[Terri Warren, RN, Adult Nurse Practitioner]

There is no question that people get herpes on their arms and hands.  It just is unusual, and before anyone decides to live as though the lesions are herpes, it needs to be confirmed.  

Thanks for your valuable input on this issue.

Terri

[Terri Warren, RN, Adult Nurse Practitioner]

I understand why you think the virus "spread" because it showed up in a new location, but somehow, something, probably the kind of friction that occurred, caused the virus to travel along a slightly different nerve to get to the surface of the skin.  It certainly isn't the result of you being careless, the virus just picked a different path to come to the surface of the skin.

Terri

[Terri Warren, RN, Adult Nurse Practitioner]

I would agree that herpes on arms and hands is very uncommon, particularly arms.  I would strong suggest that you ask either your OB or your dermatologist for swab tests (preferrably PCR) to take home and YOU gather the swabs from the bumps ASAP after the come and bring the vials back to the doctor's office for them to send to the lab.  You would need to rub the lesions very hard, and break off the swab into the vial to be returned.  If they don't want to do that, you should ask your OB if you could come in immediately the next time you get one for swabbing.  I agree that it is very important that you find out if these are herpes or not.  I don't think blood testing would help you at all.  You've already been told you have HSV 2, so you don't need confirmation of that.  

By the way, shame on the herbalist for diagnosing something with pictures without any lab work.  That is really not acceptable, particularly with herpes which could have many different appearances.  

Also, the herpes didn't "spread" from the anus to the vagina.  It is in that entire set of nerves that serve the parts of the body from your waist to your mid thigh.  So outbreaks can occur anywhere in that area, including the cervix, which could cause the symptoms that you describe.  

It will be harder to get an accurate diagnosis of the things on your arms and hands while you are on daily therapy.  At the end of pregnancy, it is far more important to be on suppression to protect the baby than it is to sort out if these lesions are herpetic.  

Another option might be for the dermatologist to biopsy one of the lesions, and if one is fresh, they might even be able to do a quick visual diagnosis of something else, they are pretty good at that.  

Bottom line:  herpes on arms is rare, get an accurate diagnosis so you don't worry.

Terri

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A related discussion, Pregnant-Proper test for arms and hands was started.

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Thanks for your feedback.

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FYI - I went to the dermatologist today to examine the bumps on my arms that appeared last night.  He did bacterial and hsv swabs.  Results will be back in two weeks.  He said that it doesn't appear to be herpes....no blisters or fluid.  Also because they appear in different places when they show up.  I'll let you know what the results are.

Thanks!

[loz23]

Hi

I just wanted to say that I have herpes on my arm. I had it for so long and doctors kept dismissing it until one day a doctor did a swab and it came back as HSV2. I get it re-occur almost every second month and I hate it!

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Thanks Terri.  The reason I said it spread from the the anus area to vaginal is because I had never had an outbreak there...until I started having unprotected sex with my boyfriend at the time, and I had pre OB symptoms during a time we were having unprotected sex.  I felt it was a result of me be careless.  It literally appeared about two weeks later.

I will definitely ask the dermatoligist on Thursday if I can take an at home PCR swab test and the biopsy suggestion.   I haven't been taking the Valtrex daily, just for bigger OB's (like in spread areas like arms/legs).  3 so far during this pregnancy.  I'll be sure not to take it after this week so that I can get an accurate swab result.  

Thanks and I'll keep you posted.