Herpes Sore?

[LeeBrando]

Hello again Doc...

I'm not overly concerned about the question I'm about to ask you, but I wouldn't mind an answer non-the-less.

In another post, we went over HSV-1 vs. HSV-2 and how they can both apparently occur down south and on the lips, general face area, so I get that.

Here's the question:

I recently received unprotected oral sex from a escort approx. 4 days ago. Today, I noticed what appeared to be some flaking of the skin on my penis (at the lower part of the head - - The ridge I guess you could say, just before the shaft starts - - and yes, I am circumcised) .. There wasn't a lot of flaking at all, in fact, at first I thought it was some little pieces of toilet paper that had dried there and were stuck..

Anyways, there seems to be a red bump?? It's not really a bump since it's not raised, I guess you could call it a small red sore, or spot, looks a little shiny, at the location.

My general question here is: Does this sound like it could be Herpes? I suppose if it were Herpes, it would be Genital HSV-1, but there's only one red 'bumpish' spot, which is flat, and other than me playing around with it, seems painless.

Could this be the start of a Herpes outbreak, and don't they normally come in clusters that are more like ulcers, or liquid filled?

If it's not herpes, what else could it be?

Thanks Doc

[H. Hunter Handsfield, M.D.]

Of course this can happen, in theory.  Either HSV-1 or HSV-2 can infect either the genitals or the mouth.  However, oral HSV-2 infections are rare, and oral to genital HSV-2 transmission even rarer.  In my 40 years in the STD business, I have never seen a case of genital HSV-2 that apparently was acquired by oral sex.  Virtually every case of genital herpes from oral sex is due to HSV-1.

That will end this thread.  I won't have any further comments or advice.

[LeeBrando]

Okay, thanks again for the insight.

Strictly from a clinical point of view, I wonder how many cases of herpes happen like this.

1) Girl goes down on guy who has HSV-2 and acquires the virus on her lips/mouth/face etc. (Where apparently HSV-2 doesn't like to live)

2) Girl goes down on another guy, and gives him HSV-2 on the penis or groin area (Where HSV-2 is right at home)

I'm quite sure there's very little statistical data on this type of transmission, but it would be very interesting to know..

Feel free to add your thoughts if you like, I'd be interested in your opinion on that.. I know you're busy, so if it's an annoyance to you, don't worry about it.

Thanks again for the information, cheers!

[H. Hunter Handsfield, M.D.]

Read the first sentence of my reply as well as the second.  It's the question immediately before yours on this forum, about "dry itchy flaky skin" or something like that.

[LeeBrando]

Okay Doc, thanks for the prompt reply.... If this thing doesn't blister over by tomorrow or the next day at the latest, I'll assume it's not a herpes lesion, and just forget about it.

I'm still not really sure what this means,  "As noted in my reply there, the symptoms you describe are not suggestive of an HSV infection" as noted in your first reply because I didn't ask a question like this, but I doubt it matters any a this anyways - Care to post a link too whatever it is you're talking about?

[H. Hunter Handsfield, M.D.]

The additional information doesn't change my opinion or advice.  If the bump is early herpes, it will blister within 1-2 days of onset; and it is true that single lesions are less likely to be herpetic than a cluster of a few lesions.

Association with flaking suggests psoriasis or some other skin rash of the "papulosquamous" variety (of which there are many).  As already advised, see a provider (perhaps a dermatologist) if the symptoms continue.

[LeeBrando]

Forgot to mention 1 thing. Yesterday when I first noticed this red bump it had skin flaking, today there is not skin flaking at all, just a red bump... If that makes a difference?

[LeeBrando]

This is just a coincidence, nothing more.. The sore has not been there very long at all. Like I said above, I received a bbbj from an escort 5 days ago now (4 when I had written the question), and now there's a bit skin flaking along with a round, red spot.

Would it be a fair assumption that if the 'red spot' does not evolve as you described above - "red bump to blister to open sore to scab then healting over 1-2 weeks." - that it is not herpes?

What is the general time frame for it to evolve from a red bump to a blister if it is indeed a herpes sore, and don't herpes sore(s) usually come in groups, or more than one.

I'm not letting my mind get the best of me here, it's the timing that is a bit scary to me (incident with escort to "showing" of the red bump) - I'm sure it could be something else as well, but I want to properly monitor it, know what to expect, and what time frame (general) to watch out for.

Thanks for taking the time, especially on a Sunday!

[H. Hunter Handsfield, M.D.]

Welcome back to the forum.

By chance, this is the second question in a row with essentially the same symptoms and concern about herpes.  As noted in my reply there, the symptoms you describe are not suggestive of an HSV infection.  As for the small red bump, sore, or whatever it is:  although you don't say so, it seems you are describing something that has been there a while and hasn't changed much.  If so, it can't be herpes.  Herpes outbreaks generally evolve from red bump to blister to open sore to scab then healting over 1-2 weeks.

As for non-HSV causes, there are plenty of skin problems that come and go; just because your penis is involved and because something has occurred before doesn't make it herpes.  If the problem(s) persist or you remain concerned, see a health professional.  But in the meantime, you can be confident herpes isn't the problem.

Regards--  HHH, MD

[gracefromHHP]

obviously meant to post this in your std forum post :)

[gracefromHHP]

you tried to post on a post that wasn't yours in the std expert forum so it was bumped over here.  since you already have a paid post going there, follow up there and get your money's worth.

grace