Confused

[eddy4763]

Hello Doctor. I have a wierd issue. As my posts in the past I have discussed about some blisters coming out in my pubic region. You have told me before that they were not herpes and just probably folliculitis, but now there is a problem. I did not have a herpes blood test done before due to the fact that i have no insurance, but after these things did not stop coming out I decided to take one and pay for it cash. Here is my dilemma. These blisters are clustered but have not pain. They have never become open ulcers but the blisters themselves turn into scabs while others may just swell down and disappear. This is all in the pubic region and the farthest it has ever been to the penis has been near the base but clearly where hair is growing. My problem comes to be that the blood test came out positive. I am not sure what exam i took, but I do know that for some reason the results took about a month to come in and he said he received it with no numbers just saying HSV-2 Positive. I am not sure if I even took an IGG or and IgM exam. From what i have read in the forums and in the FAQ, herpes blisters have at least a month between outbreaks, but these blisters tend to sometimes are a week or two apart. This month alone I have had them appear three times. They are not painful but they are indeed disturbing and itchy at times and my lymph nodes do not fail to swell up everytime. They dont start off as red bumps, but rather as tiny blisters that get bigger over a day and then turn sort of white and then become scabs. My doctor (before the results) gave me Bactroban to apply over the blisters and after a couple of days (5 the most) the blisters turn into scabs, but I dont know now if it was actually the medication taking effect or it was the normal process of the body healing the blisters. Also, these things tend to spread, but stick only to the right side of the pubic region. There was one time when my doctor for some reason peeled the blisters off, which one of them got about the size of an eraser because i was picking on it, and left it oozing some clear liquid and apparanltly the lower part of my shaft got some of the liquid on it and the following day a couple of more blisters appeared, again still in a cluster. Everytime these blisters come out it doesnt fail that within the week they are out, another cluster appears around the blisters that are healing. I have had these things coming out for over a year now with always the same severity and symptoms. I just have a few questions?

1) If this is herpes what can explain the continuous recurrence in such a short period of time?

2)With Herpes After one cluster appears can another set of clusters appear after?

3)How could I have contracted it in the pubic region?

4)If it is recurrent why are my lymph nodes always swelling up?

5)Do you think the blood test was a false positive and I should have another one taken?

Thank You for all your help.

[H. Hunter Handsfield, M.D.]

Not knowing exactly what blood test was done, I cannot confirm that you have HSV-2.  But assuming it was a reliable test (e.g., HerpeSelect), that the result was truly positive (ELISA ratio 3.5 or greater), and that you're not talking about an IgM antibody test, then you are infected with HSV-2.  But check out these details with your doc.

Assuming your test is positive, it doesn't necessarily mean that the symptoms you describe are due to herpes.  It doesn't sound like it; almost certainly you have folliculitis.  But the way to know is to see a doctor knowledgeable about herpes and other skin conditions, like a dermatologist.  If s/he suspects herpes, a culture or PCR test on the lesions can be done.

1) Herpes alone cannot explain your problem.

2) Herpes rarely recurs more often than every 4-6 weeks; between outbreaks the skin is entirely normal.

3) You probably didn't contract pubic area herpes.

4) Any inflammation in that area of the body--herpes, folliculitis, or other conditions--can cause lymph node inflammation.  However, recurrent herpes rarely does so; only initial infection typically causes lymphadenopathy.  Therefore, this is further evidence that herpes isn't the cause of the lesions you describe.

5) I cannot judge whether your HSV-2 test might be false positive.  See my comments about the specific test you had.  If in doubt about the test, have another one and make sure it is a HerpeSelect brand HSV-1 and HSV-2 test.

Bottom line:  This needs to be managed by a knowledgeable health care provider, not through online advice from me or anyone else.

Good luck--  HHH, MD

[eddy4763]

One more question doctor. Is it strange that the hospital did not send any numbers with the result of the exam?