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Folliculitis or herpes?
To Whom It May Concern (Or Who May Ever Address This):
About around the time we started seeing a young woman, I began to notice several pink areas in my pubic area. For a few days these spots were slightly sporadic, with one or two pimple-looking postules. There was neither any itching, nor burning sensation, nor tingling feeling. They quickly died down and I immediately saw my doctor. He saw the remnant of one postule and diagnosed it as folliculitis, despite my concerns about herpes.
This last week, following an occasion of sexual intimacy with her, I began to experience a clear discharge from my penis. It was painful for me to urinate; when I did the urine was dark and yellow; I also began to experience itching and slight burning sensations.
The next morning I checked in to see a nurse practitioner, and she performed a full visual examination. After two minutes she said, again, and with confidence, that the pink areas in my pubic area were indicative of folliculitis -- nothing more.
My genitals remain sensitive and I have to urinate frequently and sometimes with pain. The pink spots remain, also. The emotional and psychological distresses are intense, and I find myself second-guessing (really, third-,fourth-,fifth-guessing, and so on) marks and sensitivities all around my body. It prevents me from seeing this woman out of fear that I may spread an infectious disease and makes me extremely concerned about my future.
I guess my questions here, for anyone reading or interested, or with experience in the matter, are:
1. Can folliculitis be a common misdiagnosis for herpes?
2. About how long would it take for herpes to manifest?
3. Must ulcers or open sores be present for herpes to be manifest?
4. Would my symptoms be indicative of another STD, a kidney infection, etcetera?
I would appreciate anyone's time and attention in answering these questions. Thanks so much!
About around the time we started seeing a young woman, I began to notice several pink areas in my pubic area. For a few days these spots were slightly sporadic, with one or two pimple-looking postules. There was neither any itching, nor burning sensation, nor tingling feeling. They quickly died down and I immediately saw my doctor. He saw the remnant of one postule and diagnosed it as folliculitis, despite my concerns about herpes.
This last week, following an occasion of sexual intimacy with her, I began to experience a clear discharge from my penis. It was painful for me to urinate; when I did the urine was dark and yellow; I also began to experience itching and slight burning sensations.
The next morning I checked in to see a nurse practitioner, and she performed a full visual examination. After two minutes she said, again, and with confidence, that the pink areas in my pubic area were indicative of folliculitis -- nothing more.
My genitals remain sensitive and I have to urinate frequently and sometimes with pain. The pink spots remain, also. The emotional and psychological distresses are intense, and I find myself second-guessing (really, third-,fourth-,fifth-guessing, and so on) marks and sensitivities all around my body. It prevents me from seeing this woman out of fear that I may spread an infectious disease and makes me extremely concerned about my future.
I guess my questions here, for anyone reading or interested, or with experience in the matter, are:
1. Can folliculitis be a common misdiagnosis for herpes?
2. About how long would it take for herpes to manifest?
3. Must ulcers or open sores be present for herpes to be manifest?
4. Would my symptoms be indicative of another STD, a kidney infection, etcetera?
I would appreciate anyone's time and attention in answering these questions. Thanks so much!
A related discussion, can it be herpes was started.
A related discussion, Worried about herpes or HIV was started.
MEDICAL PROFESSIONAL
As for herpes, you already have my thoughts that you don't have it, and both your NP and doctor agree. Follow their advice to see a dermatologist to learn the cause of your pubic area rash. But forget about herpes and do not ask me about it again.
As for the transient urethral discharge, it's good you were tested and negative for gonorrhea and chlamydia. If your transient discharge does not reappear and you have no more symptoms along those lines, most likely there is no problem. But if the discharge reappears, get reexamined to check for NGU.
That will be all for this thread. Take care.
As for the transient urethral discharge, it's good you were tested and negative for gonorrhea and chlamydia. If your transient discharge does not reappear and you have no more symptoms along those lines, most likely there is no problem. But if the discharge reappears, get reexamined to check for NGU.
That will be all for this thread. Take care.
Hi Dr. Handsfield,
Thanks again for taking the time to read these posts and answer my questions.
I received my results today and they came back negative -- everything from chlamydia to hepatitis -- with the exception of herpes, for which I was not tested by blood. Noting my concerns over this condition in my pubic area, the doctor recommended I see a dermatologist, as both he and a nurse practitioner both saw me and verified that I do not have herpes -- this despite inflammation in my pubic area one week ago and the persistence, sometimes, of painful urination, that white discharge that lasted so shortly, and a sprinkling of red/pink areas in my pubic area.
What are your thoughts?
Thanks again for taking the time to read these posts and answer my questions.
I received my results today and they came back negative -- everything from chlamydia to hepatitis -- with the exception of herpes, for which I was not tested by blood. Noting my concerns over this condition in my pubic area, the doctor recommended I see a dermatologist, as both he and a nurse practitioner both saw me and verified that I do not have herpes -- this despite inflammation in my pubic area one week ago and the persistence, sometimes, of painful urination, that white discharge that lasted so shortly, and a sprinkling of red/pink areas in my pubic area.
What are your thoughts?
MEDICAL PROFESSIONAL
Could be any of the same problems we already discussed. Just get your test results. I won't have any further comments until then.
Dr. Handsfield:
Thanks, again, for your swift reply. I will advise you of whatever I find out on Tuesday.
New symptom: The area surrounding the tip of my penis appears slightly inflamed. Urethritis? Gonorrhea?
Thanks, again, for your swift reply. I will advise you of whatever I find out on Tuesday.
New symptom: The area surrounding the tip of my penis appears slightly inflamed. Urethritis? Gonorrhea?
MEDICAL PROFESSIONAL
Thanks for the additional information. Your description continues to suggest folliculitis. Herpes is not the issue here.
If the "itching and tingling" refers to your penis, especially feeling inside (i.e. the urethra), they are typical for all 3 of those STDs.
Let me know what the test results show. But I'm a little surprised the NP didn't already start treatment. Did she examine you and look for abnormal discharge? It seems highly probable you have NGU and most likely you will need treatment even if the gonorrhea and chlamydia tests return negative. I recommend your partner be retested, even if your tests are negative; same for her other partner. If and when you are given an antibiotic, your partner also needs to be treated.
If the "itching and tingling" refers to your penis, especially feeling inside (i.e. the urethra), they are typical for all 3 of those STDs.
Let me know what the test results show. But I'm a little surprised the NP didn't already start treatment. Did she examine you and look for abnormal discharge? It seems highly probable you have NGU and most likely you will need treatment even if the gonorrhea and chlamydia tests return negative. I recommend your partner be retested, even if your tests are negative; same for her other partner. If and when you are given an antibiotic, your partner also needs to be treated.
Dr. Mansfield:
Thank you for your prompt reply.
The rash/pink areas in my pubic area first appeared as sores; one or two became postules, then all quietly died down and remain faint. They enlarged again the night that I experienced the discharge. None appear on my penis or testicles; they remain confined to my pubic area.
Gonorrhea, chlamydia, and NGU do sound more likely, but again with some of the itching and tingling sensations I have experienced -- could these symptoms be ascribed to any of them?
The practitioner did test for all the above. I am waiting for the results on Tuesday. I have spoken with my partner and mentioned these symptoms, and she said she had been tested and came out clean in April, and has since abstained from intercourse with another man, myself excluded.
Thank you for your prompt reply.
The rash/pink areas in my pubic area first appeared as sores; one or two became postules, then all quietly died down and remain faint. They enlarged again the night that I experienced the discharge. None appear on my penis or testicles; they remain confined to my pubic area.
Gonorrhea, chlamydia, and NGU do sound more likely, but again with some of the itching and tingling sensations I have experienced -- could these symptoms be ascribed to any of them?
The practitioner did test for all the above. I am waiting for the results on Tuesday. I have spoken with my partner and mentioned these symptoms, and she said she had been tested and came out clean in April, and has since abstained from intercourse with another man, myself excluded.
MEDICAL PROFESSIONAL
Welcome to the STD forum. There are two medical issues here and I will address them individually.
First, the rash: Initial herpes in men rarely involves the pubic area or other hair-bearing areas; the large majorty of first cases primarily involve the penis. You don't describe the detailed appearance of the rash, but on location alone -- plus the fact you had a similar occurrence before your recent sexual exposure -- argue against herpes. To the specific question: 1) A health professional's diagnosis of folliculitis is very reliable and would not be confused with herpes. 2) Initial HSV symptoms usually begin 2-5 days after exposure, sometimes 10 days, very rarely up to 3 weeks. 3) Usually blisters first, the usually but not always open sores, scabs, etc.
Second, and your question no. 4, the discharge from your penis and painful urination: It sounds like you have urethritis, i.e. either gonorrhea or nongonococcal urethritis (NGU). NGU is more likely than gonorrhea, because gonorrhea discharge usually is yellowish (like pus) but NGU often causes clear discharge; and gonorrhea usually causes symptoms sooner, i.e. 3-5 days. But either of these STDs is possible. About one third of NGU cases are due to chlamydia, so that's a good bet as well.
You don't say what exams or tests your NP did for these symptoms. If not examined for urethritis, and if no tests were done for gonorrhea and chlamydia, return to the clinic and be sure they are done. In the meantime, you must contact your partner and tell her about this problem; she needs to promptly see her own health care provider for STD testing.
Your fear for your own health is reasonable, but it isn't the main issue here. Although STDs like chlamydia, gonorrhea, and NGU of course are important, once treated there are almost no complications or long term health implications for men. But women often get serious complications which can come on suddenly and early. It is very important you speak to your partner while you also get additional evaluation yourself.
Bottom lines: Don't worry about herpes, but do get checked out and advise your partner right away about your urethritis. Please report back after you and your partner are reevaluated and let me know what is found.
Good luck-- HHH, MD
First, the rash: Initial herpes in men rarely involves the pubic area or other hair-bearing areas; the large majorty of first cases primarily involve the penis. You don't describe the detailed appearance of the rash, but on location alone -- plus the fact you had a similar occurrence before your recent sexual exposure -- argue against herpes. To the specific question: 1) A health professional's diagnosis of folliculitis is very reliable and would not be confused with herpes. 2) Initial HSV symptoms usually begin 2-5 days after exposure, sometimes 10 days, very rarely up to 3 weeks. 3) Usually blisters first, the usually but not always open sores, scabs, etc.
Second, and your question no. 4, the discharge from your penis and painful urination: It sounds like you have urethritis, i.e. either gonorrhea or nongonococcal urethritis (NGU). NGU is more likely than gonorrhea, because gonorrhea discharge usually is yellowish (like pus) but NGU often causes clear discharge; and gonorrhea usually causes symptoms sooner, i.e. 3-5 days. But either of these STDs is possible. About one third of NGU cases are due to chlamydia, so that's a good bet as well.
You don't say what exams or tests your NP did for these symptoms. If not examined for urethritis, and if no tests were done for gonorrhea and chlamydia, return to the clinic and be sure they are done. In the meantime, you must contact your partner and tell her about this problem; she needs to promptly see her own health care provider for STD testing.
Your fear for your own health is reasonable, but it isn't the main issue here. Although STDs like chlamydia, gonorrhea, and NGU of course are important, once treated there are almost no complications or long term health implications for men. But women often get serious complications which can come on suddenly and early. It is very important you speak to your partner while you also get additional evaluation yourself.
Bottom lines: Don't worry about herpes, but do get checked out and advise your partner right away about your urethritis. Please report back after you and your partner are reevaluated and let me know what is found.
Good luck-- HHH, MD
You are reading content posted in the STDs Forum
Herpes spreads by oral, vaginal and anal sex.
Herpes sores blister, then burst, scab and heal.
STIs are the most common cause of genital sores.
Millions of people are diagnosed with STDs in the U.S. each year.
STDs can't be transmitted by casual contact, like hugging or touching.
Syphilis is an STD that is transmitted by oral, genital and anal sex.
