Herpes? 2 early negative tests

[boomboom221]

Thanks for taking the time to answer my question. I had unprotected sex about a month ago with a girl whose sexual history I do not know. The sex lasted about 4-5 minutes. About a week later I noticed a pink bump on the shaft of my penis and multiple bumps in my pubic hair that caused no pain. I went to a doctor (not my own GP) and received a culture test for the bump on my penis...it came back negative 5 days later. The bump on my penis eventually went away (no bursting or scabbing). Two weeks later I went to my own doctor who was only able to see the bumps or "lesions" in my pubic hair and said it looked like folliculitis and gave me a week's worth of Amoxicillin (bumps in pubic hair slowly fading). I also had a herpes 2 gG test (3 weeks from possible infection) that came back negative. A couple days after I went to the doctor I noticed another whitish/pink bump on my penis (different spot on penis) that went away in a few days without bursting or scabbing. I am now 4 weeks from possible infection and i now have two very small white/pink bumps (side by side) on the head of my penis. The head of my penis has a throbbing feeling but not painful.
My questions are: Does herpes jump around from area to area like these bumps have? Does a herpes outbreak typically last 4 weeks with sporadic "lesions"?

Please help!

Thanks!

[H. Hunter Handsfield, M.D.]

This would be a very atypical presentation of genital herpes.  Something else almost certainly is responsible for your symtpoms.  Herpes doesn't behave the way you describe.  In response to the specific questions, herpes indeed doesn't "jump around" in the way you describe. Although the initial herpes outbreak can last 2-3 weeks, 4 weeks definitely is too long.  Further, herpes lesions are not "bumps"; they are blisters that turn to open sores or scabs.

Consider seeing a dermatologist if the problem persists.  But most likely it is not herpes or any other STD, and the problem most likely isn't related in any way to the sexual encounter you describe.

I hope this helps.  Best wishes---  HHH, MD

[boomboom221]

Thank you for your prompt response. This will be my last post...

An update to my symptoms: I noticed today that there is red skin where the "lesions" on the head of my penis are. The red skin is almost like a streak that leads to the opening of my penis. The lesions themselves do not hurt but the head of my penis has an unusual throbbing sensation that occurs intermittently. Does this sound like herpes? Since I had both the culture test and the gG test after 3 weeks (both negative), would you recommend that I have another blood test? If so, when would make the most sense...6 weeks from possible infection?
Thanks again for your help/advice.

[H. Hunter Handsfield, M.D.]

This description doesn't sound any more like herpes than the original one.  Of course I cannot give a definitive answer without direct examination and I don't speculate about non-STD problems.  Seeing a health care provider, perhaps a dermatologist, is the only practical way to figure it out.  You're never going to get a definitive answer by online investigation.  In the meantime, you can be confident herpes isn't the cause.  Feel free to have another blood test 3-4 months after the exposure, if you remain unconvinced.  You can expect a negative result.

[boomboom221]

Doctor, I went to my GP yesterday to have him look at the two new bumps that I have on the glans (directly below the opening and to the left of the opening). I had a very uncomfortable pulsating feeling on the right side of the glans yesterday (especially when I went to sleep).

My doctor said he didn't think they were related to the bumps that had appeared in my pubic hair and that a culture test would be pointless because one is 7+ days old and the other is 4 days old. Again, nothing has bursted or scabbed and the lesions don't appear to be fragile or liquid filled (If I touch them there is no pain). However, I now believe that my left inguinal lymph node is swollen. Is that located in the pubic region?

This morning I also noticed that I have a few red bumps with hairs growing out of them on my stomach and and rib cage. Does folliculitis spread?

My doctor said he could not make a definitive diagnosis but believed that since there was an unprotected sexual encounter that it had to be either herpes or warts and couldn't think what else it could be. He told me to see a urologist since they would specialize in this type of matter.

Do you think it would be more appropriate to see a dermatolgist rather than a urologist?

Does any of this seem more like herpes?

Do lesions always burst or crust?

[H. Hunter Handsfield, M.D.]

Get this straight:  you do not have herpes.  HSV lesions ALWAYS progress from bump to blister to sore to scab to healing over 1-2 weeks.  Herpes is not a possible epxlantion for your problem.  Let that idea go.

If the lesions are shiny pink, and especially if some of them have a "dimple" in the center, ask your doctor about molluscum contagiosum.  Or follow your own instinct and see a dermatologist, who would instantly recognize MC.  MC is a minor infection, often but not always sexually acquired, that is common in the pubic area.

[boomboom221]

Good evening Doctor H,

I went to my dermatologist to have him check out the one lesion that remained and a reddish rash on the head of my penis (Two lesions had faded into a rash). From what he was able to see (the other lesions had faded away) he did not think it looked like herpes. He thought the lesion was MC and the rash he wasn't sure of. He told me to apply hydrocortisone for a week and if that didn't clear things up to apply thin layer of of Aldara on Mon., Wed. and Fri of the following week. The suspected MC is smaller and the reddish rash is slowly fading.

Per your advice, I am waiting until I hit the three month mark before I get retested for Herpes (I need the test results...I have been absolutely freaking out...not really eating, drinking or sleeping).

I had inguinal hernia surgey this past Friday...and everything seemed to go fine except that today I noticed I have a sore (that is scabbing) directly above my incision, but not touching, in the pubic hair region (had to shave area for surgery). This is covered by the tape that is covering the area where the incision was made. I have an appointment to see my surgeon on Tuesday. I have called him and he is aware of this situation.

I know you have said from the history I have given you that I do not have herpes but this sore is now freaking me out even more. I have read that surgery can be a trigger for an outbreak. Would this cause the outbreak to occur at the exact site of the surgical incision or would the new "outbreak" appear close to where the other lesions originally appeared?

Side notes, my pubic hair was shaved for the surgery. My GP had given me antibiotics a few weeks back for what he thought was folliculitis in my pubic hair. That was before the "lesions" on the head of my penis appeared.

Thank you for your time and advice during this very stressful time in my life.

[H. Hunter Handsfield, M.D.]

I have no more comments.

[boomboom221]

Good Afternoon, Dr. Handsfield.

I just received my test results after 11 weeks and a day:

HSV 1 IGG: 0.07 (Negative)
HSV 2 IGG: 0.02 (Negative)

Can I take these as final and move on?

Thank you very much for all of your help/guidance during this very difficult time for me...this is truly a wonderful service that you and the other Doctors provide.

I am going to take this whole experience and make some serious life changes.

Thanks again!!

[H. Hunter Handsfield, M.D.]

This really should not have been such a "difficult time" for you.  As I said originally, herpes never was in the picture as a possible explanation for your symptoms, and I'm not the one who recommended you be tested for it.  But congratulations on the negative result.  Indeed you can "take these as final and move on".

Thanks for the thanks about the forum.  Best wishes--  HHH, MD