STDs Expert Forum
Sore on Chest
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The STD Forum 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.

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Sore on Chest

Doctors:

First I want to thank you for running such an informative forum.  I know your time is important, so I will make this question as concise as possible.  I am a 26 year old heterosexual male.  I have not been sexually active in ~3 years.  Roughly 11 months ago, I tested negative for HSV 1 and 2 via HerpSelect.  I had trouble getting a hold of the Dr. that did the original test, and actually had myself tested again from a walk in lab a second time four weeks after the first test.  This test was negative for both types as well.  My question is this.  For the second time in around 8 months, I have a single sore right around 2 inches under my left peck.  What scares me is it looks like pictures of herpes I have seen on numerous websites.  My chest is also sore around an inch and a half around the actual lesion where the skin looks nomal.  How accurate is the HerpSelect test, and would it be common for a lesion to manifest itself in this area? I have never had any suspicious legions in my genital region besides for a burning urethra which was diagnosed as stressed induced prostitutes by a urologist. Also, yesterday, I (stupidly) picked at the lesion.  When I did so there was no puss that came out, but almost a white/ cloudy fluid followed by clear/yellow body fluid.  Does this sound like a manifestation of herpes?  If not herpes, what are some of the differential diagnoses?  It does not appear to be an ingrown hair or folliculate based on pictures I have seen.  I really have no chest hair to speak of.  It just seems rather odd to me that something would show up multiple times in the same spot.  Should I operate under the assumption that I do not have HSV, or should I look into the matter further?  Your help is much appreciated!
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Welcome to our forum.  Your post does not tell me why you are concerned that the recurring lesion on your chest might be herpes other than the fact that it recurs.  There are many other sorts of recurring lesions which occur including a long, long list of dermatological problems, recurring folliculitis (which can occur even in areas where it is not clear that there is a lot of hair, or other processes.  There is nothing in your post to suggest that you should be concerned that this might be a recurring herpes infection and I see no need for further testing.  

With regard to the lesion, I urge you to stop picking at it. This can lead to secondary infection.  If the problem is troubling you, the next time it occurs you might show it to your doctor for his/her opinion as to what it might be.  

Hope this comment is helpful. EWH
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Hi Dr. Hook,

Sorry for providing so little detail.  Ever since my stress induced prostate problems, which I originally did not know what is was, I have always been concerned with STDs, as I probably did too much research.  For some reason HSV is the first thing I thought of with the sore on my chest, as it looks like pictures online.  I know you said not to worry about it being HSV, and I have taken that advice, but if you could answer a few nick picky questions for me, this would give me even more comfort, and hopefully put this to bed for sure.  How accurate is the HerpSelect test.  If “in theory” the chest lesion were to be HSV induced, would the test pick it up accurately, or does the test produce lots of false negatives.  Also, I know herpes likes to stay below the waist, but how often do you see cases outside of athletes (wrestlers) where the lesions would be on the trunk.  I am assuming if it on the chest, the virus reservoir is in a different set of nerves in the spinal column than that of genital herpes.  Is this an accurate statement?  If someone were to come in to your clinic with a reoccurring sore in the exact same location that was a few months apart, what would be the first thing that would come to your mind; would it be HSV?
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300980_tn?1194933000
there HerpeSelect test detects over 97% of HSV-2 infection, perhaps a slightly lower proportion of those caused by HSV-1.  In your case, when the test results are considered along with everything else, HSV is just not in the running as a possiblity.  

Cases of HSV-2 outside of the "boxer short" distribution are rare.  

Indeed if you had an infection of the chest, a different set of nerves and nerve roots than those for the genital area would be involved.  

If someone would come to see me tomorrow my assessment would be based on my exam findings.  

I really think you are over thinking this.  I urge you to stop worrying about HSV and to stay off of the internet.  EWH
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