STDs Expert Forum
Herpes risk?
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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 risk?

I am a 38 year old old white male - primarily heterosexual but have occasionally engaged in mutual masturbation with other men. I have a significant concern about STDs, especially herpes, and normally take care to avoid any unprotected genital to genital contact.  However, I recently received a massage from another male of unknown sexual history that went further than intended. The other guy ended up "dry humping" me for a a few minutes, rubbing his unprotected penis between my buttocks. There was no penetration. I also briefly inserted my penis in his mouth.

17 days after this encounter I noticed an unusual bump at about the midway point of my penis.  I have a number of Fordyce spots on my penis, and this bump is among several of them. However, this bump appeared a bit larger (~2 to 3 mm diameter), raised and there was a small red rash in an asymmetric pattern around it. The bump was slightly painful (really more like a bit sore) to touch initially. After 6 days, there's been no real change in the bump - slightly less red and not at all painful now. It has not burst nor weeped any fluid over the last 6 days.  I've had ingrown hairs/pimples at the base of my penis a few times, but never anything in the middle of the shaft.  A day or so after finding the bump,  I also began noticing an itching/burning sensation around my anus - not really painful and admittedly a possible symptom of my obsessing about this episode. No pain during bowel movements. No other symptoms.

What are the changes that this is a result of herpes or some other STD? Are there other possible causes for this bump on penis?
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Welcome to the Forum.  I'll try to help. The chances that this is an initial outbreak of HSV are quite low however the only way to be completely sure is to test. Even experts are wrong in their clinical diagnosis of herpes about 20-25% of the time and this if there are any suspect lesions, testing is recommended.  I suggest you see if you can get a culture or better yet, a PCR test of this lesion- the lesion does not need to be a blister or open sore to be tested.  Blood tests will not be helpful in sorting this out.  

As far as whether it is HSV or not, I doubt it. The exposure you describe was low risk.  While HSV is transmitted through direct contact and thus, in theory could have been transmitted in this way, practical experience has taught us that penetrative sexual contact is the most common mode of transmission.  I'll presume your partner did not have lesions present at the time of your contact.  if this is the case, we now estimate that the risk of acquiring infection form an asymptomatic partner who has HSV ( and there is a good chance that he did not) is in the neighborhood of 1 in 10,000.   That does not mean that it doesn't happen but is certainly doesn't happen often on a case-by-case basis.  

If I had to guess, this is likely a cyst, folliculitis or some other benign skin process but admittedly, that is only a guess.  The best thing you can do is have a knowledgeable clinician take a look.  

I hope my comment is helpful. Take care. EWH
3 Comments
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Thanks Doc. This is helpful.  

I have a coulple of follow up questions. If this bump on my penis were HSV, would it be more likely to be HSV 1 from the oral exposure, or HSV 2 from the genital exposure to my anal area?  Is it possible for an HSV 2 blister to appear someplace other than the point of exposure?  Finally, if the bump were HSV, would you expect the lesion to ulcerate and scab or might it just resolve without this step?
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This question of what this might be cannot be answered.  If there is a concern you should, as I alreay said, be examine by someone who can test as needed.

HSV it transmitted by direct contact.  A HSV lesion woul o not be expecte to occur at an unexposed location.

Typically if this was HSV, it woul be expected to ulcerate.

I'll repeat one last time- instead of trying to sort this out on line, you should be examined.  Playing on-line "what if" games is not in your best interest, whether you have HSV an need to know or, more likely, you don't and need to be reassurred.  EWH
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H. Hunter Handsfield, M.D.Blank
University of Washington
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Edward W Hook, MDBlank
University of Alabama at Birmingham
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