6 Month HerpeSelect Test

[scaredwitless]

First off, thank you doctor for the invaluable service you are providing with this website.
Approximately 7 months ago, I engaged in unprotected vaginal and oral sex with a partner who stated he was STD free. He had been in a 3 year monogamous relationship prior to our brief relationship and had had no other partners between that relationship and I. Shortly after the first sexual encounter, I noticed 3 liquidy scratch-like lesions on the mons, just above where the pubic hairline stops. I thought nothing of it because it was a few days post Hurricane Wilma and I thought perhaps it had something to do with the water. They "scabbed" over and I never saw them again. About 2-3 months ago, I noticed a small scratch in a similar area, which never scabbed over and I thought nothing of it again because I was having my menstrual cycle and I usually get very itchy and irritated during that period. However, during my last menstrual cycle, approximately 3 weeks ago, it happened again, and this one scabbed over. This time I was extrememly concered so I visited my GP for a HerpeSelect test. It had been approximately 25 weeks post the first episode of these lesions. The HerpeSelect test returned the following:
HerpeSelect ELISA
HSV-1 .37 Negative
HSV-2 .22 Negative
Two nights ago, I had extreme itching in the general area where these lesions appear so I kept scratching. Last night, I noticed the lesion I had during my last menstrual cycle had not fully healed and there was a new one next to it, however, this one began to bleed a little.
My question is: 25 weeks since the first appearance of these lesions with a negative HerpeSelect test, should I still be worried that this is Herpes or should I stop worrying and try to find another cause for these lesions?
If this is not Herpes, what can be the other possible causes of these lesions? I am visiting my OB/GYN on Monday to raise my concerns but I would like to know what else to have him look for.
Thank you!

[H. Hunter Handsfield, M.D.]

Genital herpes is uncommon in the pubic area, and probably especially uncommon at the top range of the pubic hair area.  It sounds like you're just having folliculitis or acne.  Your skin may be colonized with staph or strep bacteria, which could result in recurrent folliculitis with symptoms like you describe.  In any case, given the blood test results, you can rest assured you don't have genital herpes.

Discuss this with your ObG, as you plan to do.  If things remain unclear, ask for referral to a dermatologist; specifically, make arrangements so the derm office will see you on short notice within a 1-2 days the next time you have a suspicious lesion.  But in the meantime, don't worry about herpes.

Best wishes--  HHH, MD

[scaredwitless]

Thank you for the prompt response, doctor. I perhaps was not clear with the location, but it is not the top of the pubic area approaching the bottom of my abdomen, but the buttom of the mons approaching the area near the clitoris. However, I will rest assured now and will discuss these other issues with my doctor.

[H. Hunter Handsfield, M.D.]

Sorry I misunderstood the location of your symptoms.  It really doesn't make any difference, though; the blood test result is reliable evidence you don't have herpes.

HHH, MD

[scaredwitless]

Thank you, doctor. I visited my ObG and he insisted on a viral culture as I had a recent lesion, despite informing him of my blood test results. As I await the results, what are the chances that I have HSV despite a negative test result at 25 weeks? How likely is it that I have not seroconverted at this point?

[H. Hunter Handsfield, M.D.]

Almost zero.

HHH, MD