HSV-2 lesion

[Johnherp]

Dear doc, 18 days ago I had a sexual encouter with a CSW. I briefly touched her vagina for about 5sec (not penetrated) with the inner part of my right hand (important for later) and received protected oral/vaginal sex. The following symptoms appeared after the incident:

-after 1,5day seemed like a small throat infection. No pain but little white tongue and dry throat. No pain.
-after 3 days, 'restless' legs for 2 days. On the 4th day in the evening my legs felt burning.
-my body temperature during the first week was between 98.78-99.5 F.
-after 10 days I felt little tingling at the scrotum for about 2 days and it appeared more red.

After 12 days I went to a std specialist who said my symptoms did not indicate an HSV-2 infection, also no lesions/red spots appeared in the genital area. To the doctor the area seemed normal. My fears went away and I started believing (hoping) I will come out of the regrettable incident without an std.

But: after 14 days of the incident, I got a large blister on my middle finger (the inside of the vinger, at the middle). At first I thought it was a normal blister, because I was working with screwdrivers and saws in my home. The blister appeared in the afternoon and broke open in the evening. But then I recalled the incident 2 weeks earlier, and was thinking if the blister is an outbreak of genital herpes. I recall some itching/redness at the spot 1-2 days before the blister appeared. At the moment, the broken blister does not itch/hurt or whatsoever. The blister also did not hurt/itch when it was still with the fluid in. Now the skin just looks red with some broken skin (I tore off the loose skin with my finger). The area is about 0,3cm by 0,6cm.

Does this sound as a genital herpes infection on my finger? I looked for pictures and symptomes of herpes Whitlow on the internet but it does not look like that.The blister looked like: little red/blue with 'large' quantity of fluid. It was not white/turned yellow. Thanks doc!

[Edward W Hook, MD]

For a herpes lesion to generate a flap o loose skin would also be unusual.  further evidence that it was not.  EWH

[Edward W Hook, MD]

For a herpes lesion to generate a flap o loose skin would also be unusual.  further evidence that it was not.  EWH

[Johnherp]

Thanks a million doc! I will not worry anymore. The lesion was not on the middle of the finger pad but on the middle of my finger 'as a whole'; but I guess that does not make any difference.

One final question, if possible: if it were a herpes lesion, and it bursts open, is it possible to "tear off the loose lesion-skin" like I did, or does this not occur with a herpes lesion and only with normal lesions?

[Edward W Hook, MD]

Your early symptoms were certainly not herpes.  Your current lesion is probably not either.  The lesion you describe is large and sounds much more like trauma or another process than herpes.  If you had gotten a herpetic whitlow you would have had multiple, small "water blisters" not a single one.  In addition, you lesion is at the wrong spot for a herpetic whitlow--most of these occur around the nail cuticles, not on the middle of the finger pad which is VERY resistant to infection.  Finally, herpetic whitlows do not appear, grow and burst in a single day.  

To summarize, nothing about this lesion sounds like a herpetic whitlow.  Do not worry.   Move on.  EWH