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Sore on penis
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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 penis

Dr. EWH / HHH,

In the beginning of April I had a sore on my penis. I went to a dermatologist and he said that most likely it's frictional and not herpes. It was already gone when I saw my dermatologist and was completely gone in about a week. You had the same opinion when I asked you about that.

Last night I noticed a sore around the same area. I also think I felt some tingling there earlier that day. The worst thing is that I noticed it right after having sex with my girlfriend while washing my penis. We've been together for about 7 months already and always have protected sex. But the sore was closer to the base of the penis which is not always covered by a condom if the condom slips up during the intercourse.

I'm always very anxious about things like that and I'm now thinking "what ifs." What if my girlfriend has HIV - would that put me at risk (fresh, open sore, possibly not covered by a condom during sexual intercourse)? I'm worried!

My girlfriend goes to a gynecologist every half a year for regular check-ups and she says that her doctor tests for herpes and that she doesn't have herpes. We've been intimate since February, first time I had a sore was in April but before that I didn't have sex with anyone for 3-4 months. If this is herpes I could only get it from my current girlfriend or could I have gotten it long ago but didn't have an outbreak until April?

Thank you very much!
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Welcome back.

At this point, you probably are the best judge as to whether this recurrent lesion resulted from sexual friction.  If your sexual activities -- either with your partner or by masturbation -- have been sufficiently vigorous, and sufficiently similar to the kinds of contact you had last April, then friction probably remains a good bet.

However, genital sores of any kind always raises the possibility of herpes, and herpes recurrences typically are in pretty much the same location each time, give or take an inch.  And herpes and friction probably can interact, or at least seem to.  If a herpes oubreak is just starting, friction may create an open sore sooner than would happen without friction.  As this implies, if you have herpes, probably you did not catch it recently; onset may have been weeks, months, or even years before your question on the forum last April.

Your previous thread has no mention of herpes lab testing.  That is what you need to do, i.e. have a blood test for HSV-1 and HSV-2.  If it's herpes, most likely your HSV-2 test will be positive, although it could be HSV-1.  In addition, if your current sore is fresh and moist (or "weeping"), see a doctor or clinic ASAP so it can be tested directly for HSV by a culture or PCR test.  (PCR is preferred.)

That your partner has been "tested for herpes" doesn't mean very much.  You could have it and she might not; if this is herpes, probably you had it before the relationship began, and you haven't yet transmitted the infection to her.  Also, it is unlikely her doctor has tested for herpes at every visit.

Bottom line:  Based on the information available so far, I cannot tell whether this is friction, recurrent herpes, or some other non-STD skin conditions.  For sure it isn't syphilis or any other STD.  Let me know the result of your HSV blood test if and when it is done; and if your partner had a blood test, ask her to get the detailed results (the numerical values for both HSV-1 and 2) from her doctor's office.

Regards--  HHH, MD
8 Comments
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Dr. HHH,

Thank you very much for such a quick and detailed answer! I wanted to go see my dermatologist today but it appears that he is on vacation until the end of August. The sore was fresh and moist last night but now it's dry. It is sensitive to touch though.

What about my concern about HIV transmission? What if my girlfriend has HIV - would that put me at risk of HIV transmission (fresh, open sore, possibly not covered by a condom during sexual intercourse)? I'm worried about this more than about HSV.

Thank you very much!
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239123_tn?1267651214
HIV??  Where in heaven's name does that come from??  Are you or your partner IV drug users?  Or from a country where HIV/AIDS is especially common, like in Southern Africa?  Have you had sex with men?  If not, there is no realistic chance you or your partner has HIV.  But of course if you remain concerned about it, you and your partner can have an HIV blood test.

Let's keep this discussion focused on the important issue, i.e. whether or not you have genital herpes.  Until and unless you report the results of your and/or your partner's HSV test results, I will have no further comments or advice.
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Dr. HHH,

My doctor is on vacation until the end of August so I can't get it check up until he returns. Also, the sore had almost disappeared. New skin formed so it's still pink in color and noticeable but the sore is already closed and it's not an open sore anymore. It appeared late on Saturday night and it's already much less noticeable today on Wednesday. Could this time frame be some kind of an indication to you? My dermatologist said last time that herpes doesn't dry up so quickly and that's why he thought it was not it. What do you think, Dr.HHH? Maybe the fact that it heals fairly quickly points to the fact that it might not be herpes or that it could be HSV-1 and not HSV-2?

About the HIV concern. I'm just always very anxious about this and the fact that, unexpectedly, there was an open sore during a sexual intercourse made me very anxious. So I thought that since the sore might not have been covered by a condom it's like having an unprotected sex which I always view as risky behavior. Do you think that having such a sore is not as risky as I think and that I might be exaggerating and being over-anxious about this?

Thank you, Dr. HHH!
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The speed of healing is a bit quick for herpes, but possible. Speed of healing is no different for HSV-1 versus 2.  And yes, you are overreacting about the risk of HIV in this situation.  You say nothing about the nature of the exposure, but if you have only female partners who are not injection drug users, the chance your parnter(s) are infected is zero for practical purposes.
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Avatar_n_tn
Thank you for your answers, Dr. HHH! Do you recommend that I get a blood test for HSV when my dermatologist is back or should I see him when/if another sore appears so he could do the culture or PCR test as you recommended? When I saw him about this problem when it first happened in April, the sore almost healed and he said that it doesn't make sense to cut it now for testing and that he could do a blood test but it would most likely come back indicating a presence of HSV because it's very common. Although I'm thinking that if HSV-2 is present then that's what the sore most likely is. Does HSV-1 rarely recur on penis? Am I correct?

She's not a drug user. When I was in college many years ago, they had all those scary brochures on campus about HIV and ever since then I'm very anxious about it.

Thank you!

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239123_tn?1267651214
See a doctor or clinic, then follow his or her advice.  At this point a blood test makes most sense.  Recurrent genital herpes is much more commonly due to HSV-2 than HSV-1.

That's all for this thread.  You may not keep returning with every additional little question that comes to mind.  (On most MedHelp professional forums, there are no follow-up questions/discussion at all.)

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Thank you for all your answers and help, Dr. HHH! Sorry for numerous questions.
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