STDs Expert Forum
Herpes or other STD?
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The STD Forum is intended only for questions and support pertaining to sexually transmitted diseases other than HIV/AIDS, including chlamydia, gonorrhea, syphilis, human papillomavirus, genital warts, trichomonas, other vaginal infections, nongonoccal urethritis (NGU), cervicitis, molluscum contagiosum, chancroid, and pelvic inflammatory disease (PID). All questions will be answered by H. Hunter Handsfield, M.D. or Edward W Hook, MD.

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Herpes or other STD?

Hi, On Feb 12th, I had sex with a condom with a girl.  She said that she was tested in Dec 2009 and was clean.  About 3 days later, I noticed an itchy or burning feeling around (but not on) my genitals and my right inner thigh.  A few days later, I noticed this feeling on my abdomen.  This itchy and burning feeling was not constant and varied in intensity throughout the day.

1) I have not noticed the typical bumps from herpes, but I have noticed a rash with vertical lines on both sides of the crease where my leg meets my genital area.  See pics below.  Is this herpes, crabs, jock itch or something else?  

2) Also, about 5 days after sex, I went to get tested at a clinic, and they just took blood and urine samples.  If I do have genital herpes, do I have to wait a few more months before Herpes antibodies show up in a blood test?  

3) Also I’m pretty sure I have HSV1 (oral herpes) as I occasionally get canker sores in my mouth and have had 2 blisters on my lips during my life.  On test results, how could I tell if I have genital HSV1?

Please help I'm freaking out...  Thanks!
John

Note: These pics are cropped to omit private parts:
http://www.flickr.com/photos/johnpix9999/4376587228/
http://www.flickr.com/photos/johnpix9999/4376587160/
http://www.flickr.com/photos/johnpix9999/4375839183/
http://www.flickr.com/photos/johnpix9999/4376587020/
Related Discussions
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Welcome to the STD forum.  Unfortunately, we do not examine posted photos.  Dr. Hook and I are not dermatologists and therefore not experts in skin problems other than STD.  Equally important, in our view this comes too close to a temptation to make a specific diagnosis, i.e. to practice medicine from a distance, which we don't do.

This sounds like a low risk exposure with respect to herpes and other STDs, both because of your partner's recent negative STD tests and because you wisely used a condom.  Herpes can be acquired despite condom use, but rarely.  Equally important, your description doesn't suggest herpes at all.

1) Genital herpes doesn't cause rash of the upper thighs or in the crease between abdomen and thigh.  Initial herpes occurs exactly where the body comes in close contact with the partner's virus -- in sex involving a condom, your initial symptoms would be limited to the upper penis just above the condom level.  And as you seem to know, absence of blisters or open sores is strong evidence against HSV.  Crab lice also don't cause what you describe.  Your symptoms are much more suggestive of jock itch or a superficial bacterial infection.  However, it would be helpful to know what the clinic said about it.

2) If the clinic thought your rash was consistent with herpes, follow their advice about testing for it.  But if herpes is your fear, not theirs -- i.e. if they agreed with my belief herpes is unlikely -- then I see no reason to be tested further.

3) Canker sores are not caused by HSV.  Recurrent oral herpes outbreaks are generally on the outside of the mouth, usually on the lips.  Each outbreak usually is in more or less the same place each time.  It is rare for people with oral herpes to also have genital infection.  People with HSV are immune to catching a new infection anywhere else on the body.  Therefore, you will never catch genital HSV-1, even if exposed to it.

So herpes seems very doubtful to me.  But feel free to return with a follow-up comment to describe the clinic's evaluation of the rash, especially if they thought herpes was likely.

I hope this helps.  Best wishes--  HHH, MD
3 Comments
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Dr Hansfield,

First thank you so much for writing back so promptly!  The scariest part about all this, is that I can’t really talk to anyone about this given the subject.  So having this forum and your assistance is very helpful and comforting.  =)

I have a few follow up questions:
1) Herpes would not cause itching or burning in my upper thighs or lower abdomen, right?  

2) The doctor said I could have been allergic to the girl’s perfume or lotion, which she applied near her genitals a few minutes before we had sex.  He said to be safe to get my blood and urine tested.  I’m still waiting for the results.  I may also go to a dermatologist to examine this vertical line rash.  I don’t think you answered my question about how long do I have to wait after sex before testing for HSV2 as doesn’t it take awhile for the anti-bodies to build up?

Thanks again,
Mike
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1) Correct.

2) We don't speculate much about non-STD causes and my reply above goes as far as I can with it.  I'm skeptical about the allergy explanation, but the opinion of a doctor who has done an exam generally is more reliable than a distant online forum.

I recommend against HSV-2 testing.  It won't explain your symtoms (symptoms).  If positive it will mean you have asymptomatic HSV-2 plus some other cause of the rash; and there is risk of difficult-to-interpret results.  But if you don't believe me and your doctor that it isn't herpes and feel you have to be tested, do it about 3 months from the sexual exposure.
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H. Hunter Handsfield, M.D.Blank
University of Washington
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