Herpes, Eczema, Abrasion???

[Worried79668]

I am a 30 year old heterosexual male

Day 0:  I had unprotected sex with an HSV2 + female

Day 5:  I had oval shaped dry patch of skin about 70% the size of an easer on the left side of my penis.  I rubbed away the dry skin and beneath was a reddish ulcer/ abrasion.  I also noticed two other much smaller slightly red areas that appeared as if the skin was rubbed away.  All three were in line along the length of my penis, fairly close together, on the shaft, and closer to the head.  I masturbated frequently and vigorously the days prior to their appearance.  That night a rash broke out on my waist line and the crease where the leg joins the hip.  Same night I also had a dull painful ache along the left side of my penis and left testicle

Day 6:  Mid day the ulcer/abrasion had developed a white crust. The nurse at the local health clinic did not think I had herpes.  She said the ulcer/abrasion was an abrasion and the rash was a fungus.  She did not look at either closely

Week 3:  Dry skin on the bottom of my penis

Week 5:  My dermatologist diagnosed me with eczema.  She prescribed Zocor, and the rash healed quickly.  She was unsure about the spot on my penis

Week 7:  Tested neg for HSV1 and HSV2

Week 12:  Tested neg for HSV1 and HSV2 using HerpesSelect ELISA.  Values of ~.2 and .19

Week 13 (now):  I had a dull ache and tingling on the left side of my penis on and off for about 5 days.  I then noticed two circular spots that looked like the skin was rubbed away on the bottom of my penis, on the circumcision scar line.  After picking at the spots, they began to hurt. I also have tender lymph nodes

General:  Over the past 13 weeks I have had intermittent aches on the side of my penis, as well as two occurrences of tender lymph nodes.  The ulcer/abrasion left a scar which is still present

1) When would you recommend getting retested for Herpes?
2) Do these symptoms sound like anything other than Herpes?
3) Can Herpes cause Eczema?

I appreciate your guidance.

[Edward W Hook, MD]

Welcome to the Forum.. As I read your description I felt that it really did not sound like HSV and as I read on and saw your test results this was confirmed by your laboratory tests.  You do not have herpes.  There is no need for further testing.

Let me provide a little bit of background as well.  HSV infections are very common (over 20% of adults have genital herpes and most who have it do not know it) so there is a fair possibility that you could have had sex other times with persons who had HSV and did not get it.  This is not too much of a surprise.  It turns out that most exposures to sex partners who have HSV and do not have lesions that they are aware of do not lead to transmission of infection.  In fact, some experts estimate the risk of getting herpes from an asymptomatic partner who has the infection as being between 1 in a thousand and 1 in 10,000 with many feeling that the accurate estimate is probably closer to the 1 in 10,000 figure.  

As for the "lesion" that you noticed, let me please remind you that the skin on the penis is rather thin and therefore fragile and that it is susceptible to the sorts of friction-related damage that occurs with masturbation or vigorous sex.  the lesion that you described sounds like this ..If this is what was there., that when you removed the overlying skin is was a bit shiny.

The lesions of fungal skin infections or eczema can resemble each other and what you describe could well be either or both.

This, having provided this as background, let me answer your specific questions briefly:
1.  I see no need for further testing for HSV.
2.  Eczema and fungal skin infections are possibilities as your doctors have told you.
3.  No, herpes cannot cause eczema.

I hoe these comments are helpful to you.  EWH

[Worried79668]

Ha, there is a typo above.  My dermatologist gave me VANOS for my eczema, not Zocor.  I think there was a zocor commercial on while i as posting!