Can't tell if this is Herpes

[DSmith23]

Doctor,

Back on Dec 13 I had a possible exposure to Herpes.  Starting about 5 days later, I had burning while urinating, soreness at the tip of my penis, and a few small red bumps along the edge of my head.

I went a saw a prompt care type doctor who said that the bumps didn't look like herpes (small slightly raised red bumps, no fluid), but that he couldn't be certain.  He gave me antibiotics (doxy and cipro) just in case of a bacterial cause.

A few days later I went and saw my normal doctor and had him take a look.  He also said that they didn't look like herpes sores.  They never opened up or scabbed over, they just slowly went away within a week or so.  They flared back up slightly once after stimulation, then finally went away.

At 3 weeks post-exposure, I got tested for the whole slew of STDs and everything came back clear.  I got retested at 5 weeks for HIV just to help with my anxiety.

Now, yesterday morning I masturbated.  Around lunch time at work I went to the bathroom and noticed a bunch (15-20) bright red tiny bumps along my shaft (both sides, mostly right up against my head) and a few on the head - each probably 1-2mm in diameter.  I definitely freaked out a bit, thinking that I had this whole thing behind me.  I put some Olux foam on them (I have psoriasis in on my legs and have gotten it on my penis on occasion).  As of this morning, things have settled back down a bit, but it looks like a few of them (the ones clustered on the shaft under the lip of the head) have a bit of white scabbiness to them.  Most of them are less red and some have almost gone away.

So, my questions:

1) Does this sound like herpes to you?

2) Would I have an outbreak that would be visible 4-6 hours after masturbating - how long does an outbreak take to show up after something like that?

3) Does 24 hours seem short to go from nothing, to something, to bursting, to scabbing?

3a) If this was herpes, would it be odd for only some of them to burst and scab and have some just fade away?

I know I need to be retested at 8-12 weeks, I'm just trying to get some peace of mind as to what's going on.  Clearly herpes isn't the end of the world, but I'd still rather not have it and not have to worry about it until I can be retested at 8-12 weeks.

Thanks!

[helpme7541]

Over the last week I have had a burning sensation in my groin and crotch area. I started looking around when it started burning (1 week ago today) and found a bump that looked almost like a pimple. The bump does not hurt and it looks the same as it did a week ago. I went to the doctor and he ordered a herpes test and gave me some cream and now I am scared to death. I haven't had sex in over a month and have never felt this way before. The doctor stated that there were a couple of other bumps down in the folds of my skin. None of these bumps hurt however and I would have never known they were there if I had not looked. Please help.  Does this sound like herpes or am I worried too much?

[H. Hunter Handsfield, M.D.]

Probably psoriasis, which on the penis often causes more shiny lesions and less build-up of white plaque than elsewhere.  See your dermatologist.

[DSmith23]

So, slight update.  All of the bumps except for a couple on the head appeared to have gone away completely, but today I noticed that in most (if not all) of the spots where I had the red bumps to start with, there were clear/whitish flaky bits coverings.  This does not look like my psoriasis.  I picked off the flakes and everything looks Ok, but now I'm worried again since I thought that those spots had really disappeared but clearly something was still happening.  They never turned in to visible blisters (that I could tell) and hence didn't open up.  They were never really painful or itchy either.  I don't know what herpes sores look like when they "scab over" - is it scab in the clotted blood sense (like a scraped knee), or is it really just a shiny/flaky covering?

Doc, do you still stand by your comments?

Thanks.

[anxious7]

I have psoriasis on my penis as well. I have noticed that when I stress out, my penis tends to breakout in patches of psoriasis. I too thought I had herpes so I was stressing for three weeks. My psoriasis flared up big time on my face and penis. Masturbating always makes my psoriasis get worse. THAT S**KS!!!
Good Luck! You're Fine!!

[DSmith23]

Thanks for the info.  I'm hopeful that my follow up test will be negative and I can move on from this whole thing.

Just to let you know, this forum has been an incredible resource over the past few weeks.  I'm not sure what I would have done without it.  You really are providing a great service to the community.

Fingers crossed.  

Thanks!

[H. Hunter Handsfield, M.D.]

Some general principles apply here.  First, more than 95% of the time that someone has atypical symptoms that make them worry about herpes, herpes is not the cause.  Second, when a health care provider--especially 2 different providers, as in this case--say that the problem isn't herpes, probably it isn't herpes.

Also, herpes doesn't behave like this.  Lesions appear, evolve from red bumps to blisters to open sores to scabs then heal, over 10-14 days total.

1) No, this doesn't particularly sound like herpes, both by your description and because both providers didn't think so.  2) Masturbation or other friction does not trigger herpes outbreaks.  But of course friction can irritate a preexisting problem, as might have occurred in this case.  3) Only trauma could do that, not herpes or any other inflammatory skin condition.  3a) Yes.

Even knowledgeable health care providers can be wrong, so I suppose it is conceivable you have herpes. But I very much doubt it and expect your follow up test to be negative.

Good luck--  HHH, MD