Obsessing Over Exam and Test

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Doctor HHH, thanks for your response to this post a while ago. Since then, I have taken your advice & got help for my OCD. My therapist has give me the “homework assignment” of asking this follow-up once so that I can be sure I’ve covered my bases, and to just accept your answer and move on.  To recap: Male, oral HSV1 since childhood, neg HSV2. I had written because of a mark on my penis in Sept 2007 which you said was an obvious hemangioma (it appeared suddenly, bled and “refilled” quickly, and present 6 mo. later as a small dark spot, in or under the skin, which blanches and refills when touched.) I insisted they do a PCR test (Quest). Results: HSV1-2 both “not detected”.  My concern was the results implied an initial pos for general HSV, and they then did the type-specific test which was neg. You said the only possibility was a false pos on that first part of the test. My derm. says it’s similar to an angiokeratoma.. I insisted on the PCR test because back in 2004 I had an unknown mark on my penis at the same time of a bad cold sore outbreak (incl. roof of mouth, unusual for me). The doc who examined my penis said it didn’t look like herpes and wasn’t worth doing a test on. He thought it was a shaving nick (I had shaved frequently then, and had an obvious scratch near this mark), but I was scared because it seemed more “round” to me. Since HSV is the most common cause for lesions, he said if it wasn’t a nick then it could be HSV. I had written to you years ago about that. You indicated it was unlikely to be HSV because of the immunity I’d have from childhood, but to check if anything happened again. But when I wrote to you about the more recent PCR issue, I had forgot to mention that part of the history. My question: does the earlier incident change your opinion that what I have now is a hemangioma unrelated to HSV, and that the initial PCR test was still a false pos? Can HSV cause hermangiomas?  Thanks for the help with this issue and your advice regarding OCD.

[H. Hunter Handsfield, M.D.]

Your self analysis is correct and the additional information does not change my opinion: you do not have genital herpes.

It is not true that HSV is the most common cause of all penile lesions. It is the most common cause for ulcerative lesions (i.e., open sores) -- but no red spots of the kind you describe could possibly be herpes.

Specifically:  "...does the earlier incident change your opinion that what I have now is a hemangioma unrelated to HSV, and that the initial PCR test was still a false pos?"  No.

"Can HSV cause hermangiomas?" No.

I hope this settles it. Best wishes--  HHH, MD  

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Doctor, I see I had to start a new question instead of adding to the old one.  This is the post I was referring to in case you need to see your original comments regarding the test:
http://www.medhelp.org/posts/show/406561

[H. Hunter Handsfield, M.D.]

I saw it before I responded above.