Red patches under foreskin

[SB20121234]

Hi Doctors,

I am 24 and slept with 3 girls (1 since this incident)

Last June I had unprotected sex once with a girl I was seeing after we both had STD screening tests (not including HSV). Afterwards there was a weird smell I think from her vagina. I did not shower until the next day.

Three days later I found a red rash under my foreskin. It was patches of redness and tiny red bumps. It didn't hurt. I saw a doctor the next day who said it was just a fungal thing, and another who said it looked like irritation but they took a culture for herpes, and yeast infection and bacteria. The tests came back with nothing, not even bacteria or yeast.

The rash was still there a few days later. It was just red areas, with some dry skin. Slightly shiny. Not sores. Maybe like the top layer of skin had been rubbed off, but this could have been me overanalysing. I saw my normal GP who said it was just irritation, and not herpes. It was red for over 3 weeks, so not sure if it was just me looking too closely. It hadn't gone back to zero redness so not sure what it was before anymore. No pain at all, nor any tingling or anything. No blisters nor open ulcers. Nothing like my coldsores, but I am paranoid about herpes.

About a month ago, I was overseas in New York and saw similar red patches. I went to a sexual health centre who said it was just irritation and not herpes. It went away after a couple of days and another red spot/bump appeared the same but was gone a couple of days later.

Two questions:
1) does this sound like herpes?
2) do you recommend blood test or see if it happens again and get pcr? I am concerned about false positives as I have HSV-1 and my GP said it was a bad idea since what I had wasn't at all like herpes.

Thank you very much! I am weirdly anxious about this issue

[Edward W Hook, MD]

No, yeast tests can be negative and yeast can still be present.  EWH

[SB20121234]

Thank you very much for the response! The GP thought it may be yeast but the swab for yeast came back negative. Does this rule it out as a possibility?

[Edward W Hook, MD]

Welcome to the Forum.  It's clear to me that now, despite asking 4 different health professionals you remain concerned that the redness that you have noted is herpes.  This seems unlikely- the rash you describe does not sound typical for herpes and you have been tested, at least once for HSV as well as examined multiple times.  Had your original rash been a first episode of HSV, it is likely that your culture would have been positive.  

That you have a recurring rash under your foreskin does not need to be herpes. There are numerous other recurring problems which can occur in this location, including yeast infections which is one of the things this does sound like)  

As for your specific questions:
1) does this sound like herpes?
No, see above.

2) do you recommend blood test or see if it happens again and get pcr? I am concerned about false positives as I have HSV-1 and my GP said it was a bad idea since what I had wasn't at all like herpes.
I agree with your GP.  The risk of a falsely positive test is substantial.  Since you can't seem to get by this, my advice would be to see a dermatologist, should it occur again.  

I hope this comment is helpful.  EWH

[SB20121234]

With both of these I wouldn't have known they were there if I hadn't looked. Definitely with the last one there was no feelings or sensations or itching or anything. Think it was the same with the first. Thank you again!!