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Recurrent, long-lasting herpes outbreaks
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by Brookhaven, Jul 12, 2008
Hello,
  
   Earlier this year I developed a red, itchy rash in my pubic hair. The doctor told me it was probably an allergic reaction and put me on cortisteroids, which didn't help much other than bringing the redness down. I was told that it was probably a nickel or cobalt allergy, and given an allergy patch test. However, the test came back negative. At that time I was getting small clusters of lesions that would start off as redness, turn into vesicles, then scab over. The problem was that as soon as one lesion would scab over, another would form. This went on for about two months.
  After the last of the lesions healed, I had about a month and a half with no lesions. However, I did have some mild redness and itching at the same site during this "clear period", but that would come and go.
  After a month and a half with no lesions, they came back in the same place and I went to the doctor again. This time I went to another doctor, who seemed convinced that it was not an allergy, but herpes. I requested that he do a zanck smear. He looked at it under the microscope for at least 10 minutes, and didn't seem very happy with it. He said things like "this is not a very good example of a herpes smear, but I can see some signs that it is herpes". He put me on zovirax. I took the meds, which didn't do much, and I was still not completely convinced about the diagnosis.
  That was about a month ago. The lesions that he saw are almost completely healed, but now new lesions are forming, just like before. If my previous outbreak was any indication, I have at least another month of this to look forward to. I really don't want to go back to the doctor because they all seem to be acting on assumptions and not trying to recognize that my case is not exactly normal for HSV (at least in my opinion).
  My question is this: Is it possible that these lesions take a month to heal, then form new lesions with little or no reprieve, dragging on through two months or more? When I'm "clear" should I still have redness and itching in that area?
  I will admit that these lesions do look like herpes. They itch, they hurt, and they follow all the stages normally associated with HSV. But the severity and duration seems unusual.

Thank you--
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Member Comments (30)
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by gracefromHHP, Jul 12, 2008
You can't accurately diagnose herpes based on a tzanck smear. It's a very outdated and inaccurate test and isn't recommended to be used as the only way to detect herpes any more. Your doctor not sure of what he was looking at either does not inspire confidence .

Herpes does not typically take this long to heal.  Even if you do get a type specific herpes igg blood test and it is hsv2+ it doesn't mean that this is all herpes related. I recommend that you follow up on this with a dermatologist for a further work up.  If you need help with your herpes blood test results feel free to post them here.

grace
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by Brookhaven, Jul 15, 2008
Thank you, Grace. I was turned away from taking the blood test by the dermatologist, who insisted that knowing if it was type one or two would not make any difference, and that it most certainly is herpes. He also said I need to take better care of myself so that my immune system doesn't get beat down so much by this virus. I guess that's good advice for anyone.
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by slacker101, Jul 15, 2008
Bull, you need to get this tested and confirm with an IGG Test if it is HSV 1 or 2 if it is HSV at all. Professional STD Dr's misdiagnose Herpes so you need to get this Dr of yours to do a blood test to confirm what you have here!!!
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by gracefromHHP, Jul 15, 2008
You need to find a dermatologist who is more sympathetic and not so behind on herpes that they think that it's just from not taking care of yourself properly :(  

Are you in the US? If so we can help you find a place to get a herpes blood test on your own so that you can answer the question of do you have genital herpes or not.  Keep in mind though my original advice - if this is herpes - you have more than just herpes going on.  

grace
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by Brookhaven, Jul 20, 2008
Ok, maybe I will follow up at another hospital. The thing is, if I test positive for HSV-1 it might not mean much since most adults have antibodies towards HSV-1. However, the doctor will use that as confirmation about what he already thought.
Oh, and about my status, the lesions are still here and there. Going on two months now (for this outbreak).
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by Brookhaven, Jul 20, 2008
One more thing that I think is important to point out is that although Grace says there is probably something else going on, I am finding it hard to imagine what that might be. Although I did not request an RPR, the lesions are clearly not related to syphilis so I'm pretty sure I can rule that out. I am well aware of what warts and molluscum look like, and it isn't that. I know what to look for with scabies, and it's not that either. As I said before, my patch test was negative, which pretty much rules out any kind of allergic contact dermatitis, and my KOH was also negative, so it's not fungus.  
If anyone is aware of any other likely differential diagnosis, please let me know.  
101028_tn?1348750963
by gracefromHHP, Jul 21, 2008
The patch tests look for allergic reactions, not just skin sensitivities and they also don't cover everything.  I laughed when I got allergy testing done a few years ago - came back negative for everything even though certain metals cause me to have reactions and there is a huge list of products I have to avoid.  The derm doc just looked at me and told me she told me so that the testing wasn't going to be too worthwhile but we had to cover our bases.  

MRSA is  HUGE issue right now and it frequently causes symptoms in the genital area.

There are all sorts of dermatological conditions out there too.  

Hsv1 isn't likely to be reoccuring this often. Herpes in general isn't likely to be hanging around this long.  This is why I said even if you do have herpes - it's not likely the only thing going on.

grace

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by Brookhaven, Jul 26, 2008
Thanks Grace. I got a blood test for HSV a few days ago and I'm waiting on the results. I'll post them here when I get them.

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by Brookhaven, Jul 26, 2008
One more thing: I am considering Hidradenititis Suppurativa as a likely differential diagnosis, especially if I come back negative for HSV-2.