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Stange Symptoms-lost and confused

I am a 19 year old male who has been experiencing weird genital symptoms for the past two months.  I posted here about 3 weeks prior, and in that time I've seen multiple doctors and had changing symptoms, and was hoping I could get some insight into the cause of my symptoms, since there is such a long waiting list for a dermatologist appointment.  

My genital symptoms started about 24 days ago, so I thought it best to list a timeline:

12/15/09 - Had sex with a girl of unknown sexual health early in the morning.  We had sex for about two hours with a condom; however, the condom broke during sex, and I didn't notice for about 1-5 minutes before pulling out, so there was unprotected contact.  I noticed that the skin on the girl's butt was somewhat rough, and I later when I took a closer look I noticed a number of red dots, possibly acne, but not sure. Researched herpes, I don't recall the spots on her butt looking similar to herpes blisters whatsoever, just red slightly raised bumps.  She assured me she was clean. During sex I felt a burning sensation on the tip of my urethra (most likely during the time when the condom had broken).  Two hours later I checked myself and found a raised red irritation running from the bottom of the urethra opening down to the bottom of the glans.  I also had a burning sensation during urination that disappeared after a few hours after sex and never returned. Otherwise, no concerning sensations or rashes at the time.

12/17/09 - At midnight, not even two days later since sexual encounter,  I discovered I had a strange rash on the underside of my penis, an inch under the crown/glans and the size of a nickel.  The skin was slightly red and very scaly (I thought small blisters were forming, but on closer inspection it was just well-defined scaly skin).  The skin is slightly discolored, an odd combination of red and barely noticeable yellow.  The skin is bunched together and loose looking in the rash area.  Often, when I inspect myself, the rash seems to form a /\ (arrow-head) shape across the underside of my penis. Three small cuts were also there (they are tears in the skin, but I wouldn't call them ulcers- there was and has never been any puss or crusting over of these cuts, even to this day).  I recall experiencing a tingling sensation, but I believe that to be a mental symptom since it disappeared after my first doctor appointment.

I saw a doctor (who also called in her associate) on the same day (12/17/09), who inspected the rash and did not think it was herpes or any STD.  They told me to take warm baths and apply vaseline.

12/18/09 - Strange redness started to appear on testicles.  I did not make much over it, since my anxiety focused mainly on my penile rash.

12/20/09 - Saw another doctor.  Penile rash had not improved over the weekend. Doctor was convinced it was not herpes on visual inspection.

12/22/09 - Red rash on testicles worsened after use of hot tub, but had been bothering me as well prior to the hot tub.  Rash on testicles turned from simply red irritated skin to moderately intense burning and tingling, with very small but noticeable red bumps on reddened areas.  Rash on testicles spanned both testicles, but unaffected areas on the testicles were visible.

12/24/09 - Visited same doctor about red rash on testicles, plus flu-like symptoms.  Experienced a dry cough, chills (only for one day), body aches (again, only one day), disorientation, and sore throat. I felt feverish, but never had a temperature greater than 99.4 degrees.  Was tested for both mono and strep - both negative.  Blood test showed elevated inflammation response- doctor interpreted it as an upper respiratory virus.  Told that the scrotal rash was most likely irritation / dermatitis. Told to apply hydrocortisone 1% to rash on testicles.  No improvement on penile rash - in fact, the rash had gotten redder, and seemed to become more prevalent on this day and the next.

*I later returned to the doctor because my flu-like symptoms persisted for more than a week and a half, and was prescribed Amoxicillin.  Flu-symptoms disappeared completely about 3 days later after starting the antibiotic.

12/28/09 - red rash on testicles disappeared - hydrocortisone treatment seemed to help, alleviating burning sensation for the most part, and all redness left.

12/30/09 - Noticed strange prickling sensations on scrotum, only when walking around.  When inspected no redness was found.  Penile rash still prevalent- three same cuts still present.  Strange new symptom on top side of penis- on left upper side of the penis, about half an inch down from the head, there appeared slight reddening of the skin.  Occasionally, very very small white spots appeared in this area (like a pin sized whitehead) that came and went overnight.  This has happened at least twice, with the white spots present at night, but not in the morning. The skin in this area is more sensitive than surrounding areas.  All the skin in this area is loose and wrinkly, which is not like the other healthier patches of skin on my penis.

1/2/10 - Visited doctor once more.  Redness had returned to scrotum, with slight if not noticeable burning.  Penile rash still present.  

1/9/10 - Visited doctor regarding allergies to amoxicillin.  Told the doctor that 24 days had passed and the penile rash was still present.  Received Gonorrhea and Chlamydia urine test (waiting on results to this day).  

As you can see, I'm very confused as to what I'm experiencing.  I have never had any visible blisters, ulcers, or anything that could be popped or scrapped (which makes it impossible to get a swab culture for testing HSV).
The penile rash has never hurt, itched, or burned - however, upon touch with a finger it is raw and more sensitive than surrounding skin.  Rash on testicles still persists to this day, although it has been improving over the course of the past 5 days (less red, considerably less prickling sensation when walking).  

Summary of symtpoms:
1) Red, scaly, loose skin and bunched rash on the underside of penis.  Has lasted for at least 24-25 days with slight changes in appearance.  Cuts / Tears in the skin within the rash have no healed since day one (no scaling, scabbing, puss, blood, or anything from these cuts).

2) Red burning rash on testicles, improves with hydrocortisone.  First appearance lasted about 4-6 days, followed by 2-3 days with no symptoms, then rash returned and has been once again improving with hydrocortisone
treatment

3) Slight red, bumpy and sensitive area of skin on top left shaft of penis.  On two occasions I noticed small white spots that rapidly came and went within a day.  Skin in this area is noticeably more bumpy and loose/wrinkly.

4) Strange reddening of top part of the crown.  No blisters, nothing with fluid or that could be popped - but noticeably red spots.  On close inspection today, two spots on the crown had a strange and slightly noticeable orange/yellowish tinge to them.

5) Strange red, slightly raised areas on head of penis.  Upon inspection of penis head when erect, when I squeezed blood into the head of the penis, I noticed at least a dozen of small red patches spaced around the head of the penis randomly.  These have been present for a number of weeks, but barely visible when not erect (only very slight redness).  

When erect, I cannot see the main rash on the bottom side of the penis, but I can spot the cuts.

I'm sorry for the long post, but I have been in a state of extreme anxiety for the past month with little to no answers.  I've been told by my doctor that since the rash has persisted for nearly a month, it is unlikely to be genital herpes.  Also, a rash that comes and goes with treatment of a topical steroid is certainly not herpes.  However, do any of these symptoms sound similar to herpes or any other STD?

Thank you so much for your advice!

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Avatar universal
please, anyone?

Update: When i stretched the rash on the underside of my penis, the skin was obviously yellow compared to the surrounding areas, and the rash itself seems to consist of a multitude of incredibly small dots/bumps.  This is only when stretched.  When the rash is left alone and i don't have an erection, the skin is bunched and the rash looks like a collective whole.  

Is this symptomatic of Herpes? Based on what I've researched, herpes blisters are generally larger, and these bumps are only visible under a magnifying glass?  Anyone have any insights into the cause of a yellowish rash composed of tiny individual bumps/cuts?
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Avatar universal
This is something that only a doctor can really diagnose...I believe herpes could present itself  in this fashion however it would be very unusual...you can take a blood test for herpes, but its too soon for the test to be 100 percent accurate at this point..I would say the odds are against herpes but NOT impossible here so you might want to take proper precautions (if you're going to continue to have sex at this time) until you have been properly diagnosed...
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Avatar universal
Thanks, I'm making an appointment with a urologist tomorrow.  The thing is, I've seen 3 doctors on 6 different occasions, and each time they assure me it isn't herpes, but never really give me any insight into the cause of the rash; it's always the same explanation "you've got irritation / possible dermatitis!".  But where I get confused is that I've had symptoms that have basically not changed in the past month.  How could it be irritation if the last time I had rigorous sex was 24 days ago?  

Either way, based on what I've researched an outbreak of herpes does not last 24 days, and so far I haven't seen any signs of healing and/or improvements in the appearance of the rash.  Then again, I have no idea...which makes this all the more frustrating....
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Avatar universal
Hepatitis? Ask a doctor or course, I'm just guessing here. If so, maybe get vaccinated before has time to develop? (Hepatitis has a long incubation period as far as I know).

This is just a complete guess though. I believe there are vaccines presently for Hepatitis B, and hepatitis A.
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Avatar universal
Interesting.  I looked up symptoms of Hepatitis A and B (which I match some of, such as yellow skin on the genitals, mild influenza symptoms).  The one thing that doesn't match is that I started developing symptoms 2 days after the sexual encounter of suspect, and sources say it takes 2-6 weeks before symptoms appear.
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Avatar universal
I understand..when I was infected..I experienced something similar to your case..I got infected in March of 09 and I still haven't had the classical blister/ucler outbreak...I do have constant gential irritation that has persisted since March 09...the doctors have been reluctant to say the cause of my irritation is HSV2, however I had no issues whatsover until contracting HSV2 in March...ever since then, I have had genital irritation...I have taken tests for almost everything you can imagine...the only thing positive is HSV2...
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Avatar universal
Bare w/ me here kid, because I'm about to sound really callous and unsympathetic.  

Having sex for 2 hours w/ a condom is going to be hard on your penis. It'll probably cause irritation.  Having sex for 2 hours w/ a condom that BROKE?  

The fact that your flu-like symptoms disappeared 3 days after you started taking your antibiotics points to something bacterial in your system that was causing the symptoms. HSV is a virus, it will not respond what-so-ever to antibiotics, or hydrocortisone treatment.  In fact, did you know that if you have a rash, and sit in a whirling pool of water that is hotter than normal body temperature and full of chlorine, it can exacerbate your rash? A typical HSV2 outbreak lasts about 14 days...if that. Any longer, there is something else wrong.

You seem like a very intelligent young man. Really.  Get off the interwebz, and stop googling STDs.  Your mind is working over time to come up w/ reasons for a rash that is most likely superficial. Listen to your doctor. Please. If you don't, you're going to end up driving yourself insane.  Life is TOO SHORT FOR THAT!

And please, for the love of your sanity...PLEASE carry some KY jelly w/ you along w/ your condoms if you plan to embark on 2 hour sex-capades again!

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Avatar universal
Haha, thanks sutherlandsarah.  A good kick in the *** was what I needed.

I recognize that 2 hours of sex can cause irritation.  Thing is, in the two weeks prior to the suspect encounter, I had had at least 6 hours of sex collectively (three sessions of 2 hour long sex) with a different partner whom was tested and was completely clean.  In those two weeks I never developed any other irritation besides a pimple.  It was only until I had accidental unprotected sex that I started experiencing real symptoms (not even two days...).  Then again, I suppose it could be a cumulative effect, and the skin on my penis just decided to go ahead and give up?

And you're right regarding rashes and hot tubs.  I guess in my anxious state of mind I immediately took any genital symptoms and warped it to convince myself I had genital herpes.  At this point I'm not particularly concerned about the rash on the testicles; its come and gone twice now in the span of two weeks or so, and responds to hydrocortisone.

As for the flu-like symptoms, I was already improving when I started the antibiotics, but all symptoms disappeared completely 3 days after starting them.  I guess you must be right it was some sort of bacterial or viral infection, since influenza like symptoms caused by the herpes virus wouldn't respond to antibiotics.

Again, thank you.  Your insight has given me some ease.  I'll make an appointment with a urologist / dermatologist, and try to pinpoint exactly what the hell is going on down under.  I hope that my theory is correct, and that a rash with no blisters and ulcers that's lasted this long is simply due to irritation and dermatitis (I suppose its important to mention I live on the east coast, and its freezing out).

Verysaddude: could you elaborate more on what your symptoms were?  From what I've read, herpes does not cause constant irritation for periods longer than 1-2 weeks.

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Avatar universal
Update:

When I was inspecting myself under a magnifying glass, I noticed a few strange things. There are two separate spots on the left and right of the top side of my penis.  When not erect, the skin on these spots seems to consist of small vein-like (vein like in shape) protrusions, except they are white.  When I stretch the skin, there are no veins under the skin that match up with these protrusions perfectly.  It's very strange.  The skin in these areas are a bit more sensitive than other areas.  But these protrusions are very very small, again capillary vein-like in size.  Is this symptomatic of some yeast or bacterial infection?
Helpful - 0
101028 tn?1419603004
first off put away the magnifying glass! totally unnecessary!  what you are describing while using it is normal anyways.  Actually I'd call off the crotch watch - most of what you are describing sounds like you are spending way too much time looking at your penis. limit yourself to just a cursory look over things before or after you get out of the shower every day.  


you've seen multiple providers now who don't think your symptoms look like herpes. They also don't sound like herpes.

I'd stay away from hot tubs for awhile too since if this is a fungal infection, they can just cause a worsening of the fungal infection as well as give you new infections too.

definitely if you have THAT sort of stamina, you need to be using lube both on the inside and the outside of the condom when you use it. Consider stopping and replacing the condom with a new one periodically during the sex act too.  I'd relube your female partner periodically too no matter how wet you think she might be staying. you rub your hand over your arm for 2 hours, you are going to get red and sore too I guarantee you and the skin on our arms is much thicker than the skin on our genital areas :)

grace
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Avatar universal
Thanks grace.  I usually replace the condom every 30-45 minutes, but I (stupidly) kept the same condom for two hours on this one occasion, which would probably explain why it broke and I ended up unprotected for a few minutes.

And I'm sorry, I'm obviously a bit neurotic when it comes to my sexual health.  I noticed the odd skin on the top side of my penis but had trouble determining what was going on, so I thought it best to inspect it with magnifying glass.  Obviously, it hasn't done much for my sanity, but I thought if I collected enough observations/symptoms I could pinpoint what condition I'm experiencing.

Also, I had a question regarding lubrication: if I lube the inside of the condom, doesn't that raise the chance of the condom coming off during sex?  If so, I'd just end up right at the beginning :-/

And once again, you're totally right about the irritation.  My only question is, can irritation from sex last 25 days?  I've avoided sex since then, and infrequently masturbated (3-4 times in a month since irritation).  If anything, since the first rash appeared, more areas of irritation have appeared, and none have improved thus far.  Applying hydrocortisone 1% made little to no difference, and moisterizing the area doesn't seem to help much either.
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Avatar universal
Interesting thought occured; my symptoms seem to fit Lichen Sclerosus.  I've had a change in the color of the head of my penis, and certain spots on the shaft as well, from flesh to white.  I haven't particularly mentioned them before because I thought it may be caused by blood-flow or lack there of to certain places on the penis.  But after comparing myself to a number of pictures of circumsized men with Lichen Sclerosus, I can't help but think I may be experiencing the disease.  I was wondering, Grace, is you knew anything about Lichen Sclerosus- do you think the skin disorder could cause tears, loose skin, discoloration, redness on the underside and urethra of the penis?
Helpful - 0
101028 tn?1419603004
a little lube inside the condom increases feeling for you and also keeps the condom from breaking.  

it sounds like a fungal infection more than anything which topical steroids won't help. I'd skip the urology appointment and go for a dermatologist instead at this point. if this was lichens, the topical steroids would've cleared it up too - one more reason why it's doubtful it's lichens.

grace
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Avatar universal
Interesting.  I tried making a dermatologist appointment weeks prior; of course there are so many people with skin issues and not enough doctors, the only open appointments are at least 4 weeks away.  Would it still be appropriate to see my normal doctor and ask them to take a skin sample to test for fungal infections?  Or is that something only a specialist can do?
Helpful - 0
101028 tn?1419603004
your regular doctor should be able to look for fungus. it's literally scraping off a little bit of skin with a needle and looking at it under the microscope.

grace
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Avatar universal
Following your advice I visited the doctor today.  

For the past two days I've been applying anti-fungal cream to the penile rash.  Obviously, there hasn't been a huge improvement (in such a short time), but I think I see a bit of improvement.  Nevertheless, I went to the doctor, who inspected my rash and came to the same conclusion as the other doctors I've seen: irritation, dermatitis, non-specific irritation, doesn't look like any STD.  I asked the doctor if it looked typical of a yeast / fungal infection.  He said no, and didn't feel it necessary to take a skin sample to test for fungal.  

However, since this is week 5 of continuous symptoms, he thought it was appropriate I get tested for HSV-1 and 2.  I asked him if that would be accurate, considering the suggested time before testing is 12 weeks.  The doctor said that since I've had flu-like symptoms and genital symptoms, and that I've been tested before for HSV-1 and 2 (negative for both), if I were infected with the virus I would show relatively elevated antibody levels and have negative blood test with which to compare levels.  Do you think that I can trust the results of the Igg blood test (which I'll get back next friday)?
Helpful - 0
101028 tn?1419603004
no one thinks this looks like herpes going on.

it's still way  too early for accurate testing for herpes with the blood test.

grace
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Avatar universal
Hey grace,

I took your advice and called off the 'crotch watch' for the past four days. I've also been applying anti-fungal cream to my penile rashes, which seems to help a bit.  

However, I inspected myself this afternoon and found that on the top side of my penis, in the area that was simply red (as I've described before), there seems to now be a number of very very small vesicles.  I say "very very small" because just a glance you cannot see them, but on closer inspection and with lots of light I can see multitudes of tiny grouped vesicles running pretty much across the top side of my penis, near and around the circumcision line.  The skin on which the vesicles are present is redder and more sensative than the rest of the skin above my circumcision line, but I have no pain, itching, or tingling in that area.

Also, for the past 2 weeks or so, I have had a prickling sensation on both sides of my scrotum that only affects me when I walk. It isn't a tingling sensation, more like very minute pinches and tinges of sensation periodically.  Looking at the scrotum itself I can't see any bumps lumps or vesicles, and only occasionally see a bit of redness.  I've tried hydrocortisone (makes it worse, gives me a strange tingling sensation), calamine & HCl cream (burns my scrotum), Gold Bond medicated powder (helps but doesn't get rid of the prickling), and simple vaseline.  Some of these creams and powders alleviate symptoms, but they always return over the course of the day.  The skin of my scrotum itself is often tight and tough in texture.

This is day 35 of my genital symptoms.  I honestly can't put my finger on what this is.  The grouped vesicles point to herpes, but I've had redness in that area for 35 days and never had anything vesicle like before.  Do you have any insights?
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Avatar universal
This could very well be a genital herpes infection. These symtpoms are similar to mine when I became infected.
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Avatar universal
Verysaddude, did you experience these genital symptoms for 5 weeks though?  I've had two rashes for the past 5 weeks but never any vesicles up until this point.

Also, I received my Igg and Igm test results today: I wasn't given the numbers, but the doctor said they were completely negative.
Helpful - 0
897535 tn?1295206435
Grace won't steer you wrong - go with her advice.

You got your results - you're negative - so let herpes go!
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Avatar universal
Thanks petal.  I know I took the blood test at 5 weeks, but that was on recommendation from my doctor.  Anyways....it's just frustrating that I've developed new symptoms that are so vague.  I'm going to the doctor's tomorrow, see if I can get a swab (just for safety's sake, a second opinion/test couldn't hurt).  I'm also applying hydrocortisone to the rashes- I recall having similar bumps/vesicles on my scrotum 4 weeks ago, and hydrocortisone helped clear that.  Nevertheless...there seems to be no end to this nightmare...
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Avatar universal
Yes, my symptoms have persisted much longer than five weeks. My symptoms occur to this day (10 months). There are others who have also experienced similar symtpoms to this after contracting genital HSV2. However, since your tests both have come back as negative, then it could be something else (even tho you need more time for those tests to be completely accurate). I'm only telling what my experience is as I'm sure you're coming here to hear all experiences that may relate to yours. As Grace said, its still way too early for completely accurate testing with the blood test. Still, follow-up with your doctor for any symtoms you might have. If you have any questions for me, let me know. I'll be glad to answer any questions you might have...
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