Aa
Frustrating Experience
Hi Doctor,
I'll start out by saying that I do have an issue with anxiety and I am working on it with my private counselor. I realize the service that you do for people in need is extremely helpful, so I thank you in advance.
My full history can be read in this link, if you don't mind reading it: http://www.medhelp.org/posts/Herpes/Not-sure-if-this-is-herpes/show/1894552#post_8823732
I've basically been having very recurrent red rashes on the inner foreskin. No hard bumps, no noticeable prodrome, no pain and certainly no vesicles/ulcers/weeping sores. Just mild/intermittent itching and blotchy red, sometimes flaky skin. I had a full STD panel twice. One at 4-8 weeks after possible exposure and the next at 5.5 - 6.5 months after possible exposure. All results negative. I live in Canada and unfortunately, the way they test for herpes is with HSV 1/2 IGG combination tests. I've had two negative results and I'm worried about their reliability due to the type of test. I've had multiple doctors and a dermatologist look at my rashes that do not believe it's herpes due to no blisters/painful ulcers.
I'm worried about the test and the fact that everything recurs. The rash responds very well to lotriderm (which contains a powerful corticosteroid) as well as Lamisil and ketoconazole cream. The rash can appear and suddenly disappear in a short time frame (hours). If it lingers, the creams control it in 2-3 days (sometimes 4) to the point you wouldn't know something was just there. Once the inflammation goes away after treating with creams, the skin is a bit dry and lightly flakes (very thin).
Recurrence was very high; in the first 10 months I almost always had something going on. Rash would come, I would treat and after treatment it would come right back. On and on and on. The recurrence is getting better after I stopped drying everything with a hair dryer on the cold setting. Now, it seems to be recurring every 2-3 months (only done it twice).
I'll start out by saying that I do have an issue with anxiety and I am working on it with my private counselor. I realize the service that you do for people in need is extremely helpful, so I thank you in advance.
My full history can be read in this link, if you don't mind reading it: http://www.medhelp.org/posts/Herpes/Not-sure-if-this-is-herpes/show/1894552#post_8823732
I've basically been having very recurrent red rashes on the inner foreskin. No hard bumps, no noticeable prodrome, no pain and certainly no vesicles/ulcers/weeping sores. Just mild/intermittent itching and blotchy red, sometimes flaky skin. I had a full STD panel twice. One at 4-8 weeks after possible exposure and the next at 5.5 - 6.5 months after possible exposure. All results negative. I live in Canada and unfortunately, the way they test for herpes is with HSV 1/2 IGG combination tests. I've had two negative results and I'm worried about their reliability due to the type of test. I've had multiple doctors and a dermatologist look at my rashes that do not believe it's herpes due to no blisters/painful ulcers.
I'm worried about the test and the fact that everything recurs. The rash responds very well to lotriderm (which contains a powerful corticosteroid) as well as Lamisil and ketoconazole cream. The rash can appear and suddenly disappear in a short time frame (hours). If it lingers, the creams control it in 2-3 days (sometimes 4) to the point you wouldn't know something was just there. Once the inflammation goes away after treating with creams, the skin is a bit dry and lightly flakes (very thin).
Recurrence was very high; in the first 10 months I almost always had something going on. Rash would come, I would treat and after treatment it would come right back. On and on and on. The recurrence is getting better after I stopped drying everything with a hair dryer on the cold setting. Now, it seems to be recurring every 2-3 months (only done it twice).
Thank you for your reply Dr. Hook.
I apologize for breaking the forum rules and requesting you to read through my long exchanges with Terri and going above the 2000 character limit.
The whole situation was very unsettling for me and the stress and anxiety was severe in those first 6 months. Regrettably, it's been hard for me to switch the stress reaction off, though you'll be happy to hear that I have been getting more control over it through this past year. Every once in a while I do have a relapse or go through a rough time when I get a recurrence of the rash.
I appreciate the feedback and the response you gave me regarding the sensitivity of the test...it's exactly what I needed to hear. I was unsettled due to reading many posts saying the test was "useless", and I certainly understand its shortfalls now.
Deep down, my mind knows I do not have herpes...technically I shouldn't have even needed blood tests to prove it based on all of the medical provider's assurances (my GP didn't even want to do a herpes blood test). Now, I just have to work on accepting the good news and find a way to prevent the fear from creeping back in. My fears and anxiety about discussing the issues with a girl stem from what I should and should not say about the whole ordeal. Traumatic events have a way of changing us...
I apologize for breaking the forum rules and requesting you to read through my long exchanges with Terri and going above the 2000 character limit.
The whole situation was very unsettling for me and the stress and anxiety was severe in those first 6 months. Regrettably, it's been hard for me to switch the stress reaction off, though you'll be happy to hear that I have been getting more control over it through this past year. Every once in a while I do have a relapse or go through a rough time when I get a recurrence of the rash.
I appreciate the feedback and the response you gave me regarding the sensitivity of the test...it's exactly what I needed to hear. I was unsettled due to reading many posts saying the test was "useless", and I certainly understand its shortfalls now.
Deep down, my mind knows I do not have herpes...technically I shouldn't have even needed blood tests to prove it based on all of the medical provider's assurances (my GP didn't even want to do a herpes blood test). Now, I just have to work on accepting the good news and find a way to prevent the fear from creeping back in. My fears and anxiety about discussing the issues with a girl stem from what I should and should not say about the whole ordeal. Traumatic events have a way of changing us...
MEDICAL PROFESSIONAL
Welcome to the Forum. You are not following the instructions for our Forum which ask that clients limit their questions to 2000 characters. Instead you ask me to review a prolonged exchange with Terri carried out over a year ago and then to review an excessively long series of questions and comments which can be effectively reduced to the question of just how reliable are the combination HSV IgG tests that you have had on more than one occasion in ruling out HSV for a man who has had a recurring genital rash. I think the anxiety you mentioned at the beginning of this post is showing.
Having read your past posts as well as what you've written above, I find NO reason to think that you have genital HSV and suggest to you that your tests serve to confirm this. The problem with the combination IgG tests of the sort you have had is not a lack of sensitivity but false positive tests. Yours were negative. The negative results should be believed. As multiple health care providers have told you, and as your tests show, you do not have HSV. It is past time for you to put this behind you.
As far as your statement "I fear what a girl would say to me if I told her I get frequent rashes, and "oh, by the way, a doctor had misdiagnosed me with genital herpes.", I find this a bit absurd. You have a recurring skin condition. You do not know what it is. You have been seen by number of doctors who are not sure either but it seems to get better with local anti-inflammatory treatment. You do not need to even bring up herpes, or leprosy, or any of the other possibly concerning processes that have been ruled out.
I hope this comment help. I urge you to forget about the possibility of HSV, move forward and focus you energies on dealing with your anxiety. EWH
Having read your past posts as well as what you've written above, I find NO reason to think that you have genital HSV and suggest to you that your tests serve to confirm this. The problem with the combination IgG tests of the sort you have had is not a lack of sensitivity but false positive tests. Yours were negative. The negative results should be believed. As multiple health care providers have told you, and as your tests show, you do not have HSV. It is past time for you to put this behind you.
As far as your statement "I fear what a girl would say to me if I told her I get frequent rashes, and "oh, by the way, a doctor had misdiagnosed me with genital herpes.", I find this a bit absurd. You have a recurring skin condition. You do not know what it is. You have been seen by number of doctors who are not sure either but it seems to get better with local anti-inflammatory treatment. You do not need to even bring up herpes, or leprosy, or any of the other possibly concerning processes that have been ruled out.
I hope this comment help. I urge you to forget about the possibility of HSV, move forward and focus you energies on dealing with your anxiety. EWH
To add one comment that I hadn't with Terri. The little blisters that the first walk-in doctor saw were more than likely my many tiny, clustered Fordyce spots (that I'd had since 13 years of age before sexual activity), which are whitish in appearance and were more defined due to my red foreskin. Looking at them, I can't really blame the doctor for making the mistake as they do actually resemble at least one photo of herpetic vesicles that I've seen. The thing with them, is that they are of course not blisters and do not change or break into ulcers!
(cont'd)...it used to recur almost every week to two weeks. In my mind, it's absolutely time to be past this, but my concern is not of myself...I have not allowed myself to date anyone due to lingering fears.
I fear what a girl would say to me if I told her I get frequent rashes, and "oh, by the way, a doctor had misdiagnosed me with genital herpes." My biggest fear is hurting the next person I decide I'm ready to be intimate with, by infecting them with a missed infection.
Can I trust my negative blood tests despite them being an IGG combo test? I've read negative results are reliable, and their downfall is high false positives and real positives that can't be interpreted by type. Further testing is useless as I expose myself to getting a false positive as the only test I can get is the combination.
I'm sorry for having anxiety...but please understand I've been suffering through this alone for a very long time with no resolution.
I fear what a girl would say to me if I told her I get frequent rashes, and "oh, by the way, a doctor had misdiagnosed me with genital herpes." My biggest fear is hurting the next person I decide I'm ready to be intimate with, by infecting them with a missed infection.
Can I trust my negative blood tests despite them being an IGG combo test? I've read negative results are reliable, and their downfall is high false positives and real positives that can't be interpreted by type. Further testing is useless as I expose myself to getting a false positive as the only test I can get is the combination.
I'm sorry for having anxiety...but please understand I've been suffering through this alone for a very long time with no resolution.
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.
