PLEASE HELP -- VERY ANXIOUS AND CONFUSED

[ericman]

Doctor,

I have been dating a girl who is HSV2 positive.  I am positive for HSV1 but negative for HSV2.  She has been taking 500 mg daily of Valtrex for the last 9 months.  We've had sex about 10 times in the last five months and always with a condom, except for one time.  

My problem is: since we started having sex about five months ago, I have noticed from time to time -- about every 4 weeks -- very small, flesh colored bumps on my penis, at the bottom of the shaft about a half inch to an inch above the scrotum, very close to the hairy areas.  Since I check myself compulsively down there, I sometimes pop or pick at the bumps.  After I do so, they look like very little sores and they go away in about 3-4 days.  There is no tingling, burning, or itching, and though the sores themselves are just a little painful to the touch, they do not hurt otherwise.  In addition, I feel and try to palpate the lymph nodes in my groin, and I cannot feel them nor do they feel swollen or painful.  Also, I usually only see one bump, not a cluster.

Some time in mid-December, I noticed a single whiteish/flesh colored bump about half an inch above the scrotum.  I don't remember any tingling, itching, burning, or pain -- nothing.  I popped it, and some blood and clear fluid came out.  The strange thing was that about a day later, this bump left a rather large sore that was pinkish in color, with the outer edges being a dark brown.  It almost looked like an abrasion/"rug burn."  I have seen many pictures of herpes lesions and this sore did not look like any of them -- it did not have the yellow "base" against a red background.  The sore later became moist and within a week or so began to dry and very slightly crust over.  Now, almost two months later, the sore is gone but the skin is slightly discolored.  You should also know that this bump originally appeared about 5 days after we had our one act of unprotected sex.  I went for a herpes blood test 3 weeks after that sexual encounter and was negative for type 2.

Well, about 2 days ago, I noticed about 3 or 4 flesh colored bumps down on the shaft.  I picked at them a bit and now they look like sores/cuts as well, but they are very small and again, not the classic herpes lesions.  Also, I didn't feel any tingling, burning, or pain.

What keeps me hopeful that I am okay is the following:

1. the location of the bumps (never on the head, all at the bottom part of the right side of the shaft)

2. the bumps did not look like "fluid-filled blisters" -- they were harder

2. the absence of any prodrome, tingling, pain, or swollen lymph nodes

3. the frequency of the appearance of the bumps - roughly once a month

4. the appearance of the "sores" (the bumps only become "sores" after I pick at them) and how they do not look like the typical herpes lesions

So, my questions are as follows:

1. does this sound like herpes??

2. and if not, what the heck is it??

Thank you so much for any advice.  

[H. Hunter Handsfield, M.D.]

The lesions you desribe do not sound typical for herpes, from your description.  Maybe just sebaceous glands or pimples? Or molluscum contagiosum??  Beyond those comments, I will not try to speculate what they might be.  The way to tell is not from this or any online source, but to see a health care provider.  If you don't have one or are not confident in his/her STD expertise, visit your local health department STD clinic when you have some new bumps--without manipulating them before you are examined.  Let that provider decide whether herpes testing is warranted.

Good luck--  HHH, MD

[who_is_this]

I'll only say that if you continually pick and pop anything, it will leave a sore.  I don't know what you have, but you had a test that was negative for HSV 2.  
Leave the bumps alone.

[ericman]

Doctor,

Many thanks for the quick response.  After posting my question, I went to see a urologist whom I have seen before for these bumps.  His diagnosis on previous occasions was that I had folliculitis, but upon seeing my bumps today, he thought that these could be due to some unknown viral infection, but insisted that they were not herpes.  What other virus could he be talking about?  I suspect that the urologist's diagnosis is not entirely accurate, as he saw these "sores" only after they had been manipulated and not in their natural state.  Finally, I have seen many, many pictures of molluscum and my bumps did not look anything like them.

I am in desperate need of resolution to this problem.  Thanks again.

[H. Hunter Handsfield, M.D.]

Aside from herpes, molluscum and genital warts (HPV) are is the only other viral diseases that I can think of.  If uncertainty persists, ask for referral to a dermatologist.

HHH, MD