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STDs  (Expert Forum)
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I swear I'm not this crazy
Answered by
University of Washington Seattle - WA
Welcome to the STD Forum, which 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.

I swear I'm not this crazy

by nycer56, Aug 31, 2006 12:00AM
Hey Doc,
Thanks in advance.  I've read through just about everything the internet has to offer on herpes, and I'm fairly convinced I have it, and yet the HerpeSelect test has been negative for both types.

I realize many people on here, like me, are worked up about this and skeptical about their test results.  However, having read through most of the posts here, my situation is different (I think) because I have been having actual, recurrent, genital skin irriations-- basically in the same place, always for approximately 10 day periods, and always followed by a few weeks of complete skin normalcy.

It is a little tricky to describe these outbreaks, but there is little question when I am having one and when I'm not.  The symptoms from what I can tell are fairly atypical, but they seem consistent with nothing else.  Generally, it starts with itching on the scrotum, which can be very intense (especially when I walk/run). It's like the feeling of hair you just shaved starting to grow back, sort of a like a wiry brush tickling the skin.  When I inspect closely, I can what looks like VERY small tears/cracks/crevasses in various places on the scrotum (from the right angle, they sort of glisten, a sign that there is some moisture there, I guess).  On a few occassions, they've resembled tiny paper cuts (too smallt oo culture; I went to a clinic once and they tried).  The itching is somewhat intermittent throughout the day, but lasts (on and off) for the whole outbreak.  I get a smiliar itching sensation in the buttcrack area, and also usually on the perinuem.  (When I try to look closely, there seem to be some very small tears in the buttcrack, generally right where it meets the perinuem.)  There is one other strange symptom, something I never experienced before all this started and that I only get during these outbreaks: red pimples/blister-like things will pop up on my left butt cheek.  They don't ulcerate, but they sting a little when I touch them.  They are always on the left side, never the right, and generally I learn they are there because they itch at first.  I'll only get one or two at a time, they go away quickly (a day-a few days), but they are very noticeable-- different from folliculitis, I think.  Again, all these symptoms happen at once, over a 10 or so day outbreak.  When it ends, the itching is gone, the pimples don't pop up, and the scrotum looks completely normal.

This started in Jan., about a week after a potential exposure.II've lost count, but I would say I have had 12 outbreaks since then. I really haven't gone more than two or three weeks between outbreaks.  The first outbreak was the most severe: I had two actual,open sores (base of shaft, and an inch away on the scrotum) that healed and falked off in two days.  

Been to a dermatologist (not when the first sores were there) who's been skeptical about herpes, but the creams and antibiotics haven't done anything. HerpeSelect 129 days after the exposure was negative for both types.

by H. Hunter Handsfield, M.D., Aug 31, 2006 12:00AM
Clearly you don't have genital herpes.  Your symptoms don't sound like herpes. To start, herpes in men does not commonly involve the scrotum.  More important, your description of the lesions doesn't sound much like herpes.  If you had classical symptoms, I might be willing to buy the notion of a false negative blood test.  But the odds simply are too long to be realistic, that you would both have such weird symptoms and also have a negative blood test.

If you still remain concerned about it, find a provider knowledgeable about STDs and herpes, perhaps a dermatologist, and arrange to grease the office skids so that next time you have an "outbreak" the provider will see you immediately, within a day or so.  That will offer the opportunity for both professional visual diagnosis plus a culture or PCR for HSV.

In the meantime, you can be confident that something else explains your symptoms, not herpes.

Good luck--  HHH, MD
Member Comments (6)

by Englishman, Aug 31, 2006 12:00AM
I'm not a doctor but could scabies produce those symptoms?

by littleworried, Aug 31, 2006 12:00AM
I also have had similar symptoms.  I get what are like hemeroids about every two weeks that last for about 5 days.   Very itchy and I get some minor spot bleeding on the toliet paper.  Also, in conjunction with this I get some small bumps in the crack of my buttocks that sometimes crack open and sometimes don't I was convinced it is herpes but it cycles through every two weeks or so which I believe is too often for herpes.

by needitresolved, Aug 31, 2006 12:00AM
Why don't you go to a dermatologist?

I think the doc is going to tell you, it's still unlikely to be herpres. Herpes uncommonly involves the scrotum and never recurs more than once a month. Sounds like something else is going on.

by needitresolved, Aug 31, 2006 12:00AM
Sorry mate, just saw that you have been to a dermatologist. The fact that he was sceptical, the frequency of the 'outbreaks' and, above all, the herpeselect tests is pretty strong evidence that you don't have genital herpes.

I know how you feel though, have been through a similar period of uncertainty. Came back neg for HSV2 but positive for HSV1. Still unsure whether my genital symptoms are due to HSV1 or not. I remember having a cold sore before, but these symptoms (tears in the penile skin) seem a bit coincedental.



by netship, Sep 06, 2006 12:00AM
Hi,

can you look my latest post, the newest on the forum. "evercontinuing outbreak". I have some "classical" herpes symptoms, but then I have those paper cuts like you say..and it seems to be no giving break to me. I just had general blood test, urethra and condition test made and the result is : excellent physical condition. But my scrotum itching is killing me, because it gives a few days pause and it starts again. The penis and testicle skin looks like battlefield, not still Ground Zero.
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