I have certain symptoms, my dermatologist and PCP can't give a definite diagnosis. Symptoms are:
- ulcers on foreskin and glans. They ooze yellow fluid and heal within 2 weeks. They are preceded by one big blister rather than a number of small ones,no swelling before the blister; different from book descriptions of herpes and from my own experience with cold sores (had since 1980).
- blisters later ulcers on my palate
- eyes - conjunctivitis-like symptoms, red, itchy, yellow discharge
- ulcer in the anal area, some bleeding
- ulcers on lips. Different from cold sore, no swelling, no blisters
- red spots - last time, three on my back, one on my chest, one on a toe. They do not itch, later become dark.
1) A 44 year old heterosexual, sexually inactive since 1993
2) Outbreaks in June 2007, September 2007, June 2008
3) On Acyclovir since September 2007. Did it help? Probably not, given the recent outbreak
4) Culture taken from a penile ulcer in June 2007 indicated nothing
5) Antibodies test indicates HSV-1 virus, i.e. cold sore, no surprise, had it since 1980
6) medications I take are Levoxyl (for hypothyroidism) and Acyclovir
7) I was tested for all possible STDs and I don't have any (unless you count cold sores, which sometimes are an STD)
8) I have had cold sores since 1980. Recent outbreaks have been happening every 3-4 years or so.
My dermatologist thinks the ulcers are due to HSV-1. She thinks I may have transferred it with my finger to my anal and penile area. I disagree because of 4) (culture produced nothing) and because my lips are different than under cold sores
My PCP thinks this may be Stevens-Johnson syndrome. I know SJS can be due to an allergy or an HSV outbreak (any other reasons?). My PCP has not spoken definitively about the cause. He wants me to continue taking Acyclovir.
Am I correct to disagree with my dermatologist?
I still think my penile area is not infected with HSV. Is the negative culture a sufficient test?
Should I go off Acyclovir?