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Unknown skin red sores on pelvic area
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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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Unknown skin red sores on pelvic area

History: I had sexual contact with a female about 9 days ago, I wore a condom. She and I are experiencing similar symptoms. I am having red sores on my pelvis area 4 have shown so far and they look like infected hair follicles only bigger and scab over if left alone. The sores are round are covered by red skin and is yellow/white on the inside, I took a needle and tried to remove the yellow/white part and it’s very hard to break. At this moment there are no sores on my penis. I also have inflamed pelvic lymph nodes, bad breath and clear sticky mucus coming from my throat. The female is now experiencing pain while urinating, odor on vaginal discharge and flu-like symptoms, bad breath as well and the same sores. I believe it to be syphilis but her symptoms are more like gonorrhea but uncertain. I went to planed parent hood for full tests of standard STD's and they will return in 3 weeks. The nurse that saw the skin sores dismissed it stating that it’s most likely infected hair follicles but I know its not. She also took herpes culture because it scabs like it but it’s in an unlikely area. I might have decrease in appetite because I have not eaten in 2 days but it’s most likely because I am worried. The girl stated that she was in contact with a person and had oral sex 1 week prior. I have pictures if needed. Any idea of what it could be?
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239123_tn?1267651214
By "pelvic area", presumably you mean in and around the pubic hair, or perhaps hips, groin, etc.  Conceivably this is primary herpes, but that almost always would involve the penis, not just the pubic area.  Your symptoms do not sound at all like syphilis or any other STD -- much more like folliculitis or some other superficial skin infection, not sexually transmitted.  You probably mean your inguinal (groin) lymph nodes seem swollen, which would go along with such a skin infection.  (The pelvic lymph nodes are inside the abdomen and cannot be felt on the outside.)  It is conceivable you and your partner are sharing a staph or strep infection.

Oops -- I wrote all that before I got to the end of your message.  Now I see that my judgment is exactly the same as the Planned Parenthood provider's opinion.

Another possibility might be molluscum contagiosum, a minor skin infection that can occur in the pubic area and lower abdomen, often sexually transmitted.  Your description of red bumps with hard white cores fits with MC; you should ask the PP provider about it.  If that's what you have, you caught it well before your sexual contact 9 days ago.  It takes several weeks for MC to show up.

On the other hand, your partner's vaginal discharge with odor and her pain on urination are consistent with an STD, such as herpes; or perhaps bacterial vaginosis, trichomonas, gonorrhea, or chlamydia.  Presumably she has also been checked out by PP or by her primary care provider.  If not, she should do that.

Bottom line:  Clearly you don't have herpes, syphilis, or other standard STD.  Both MC and folliculitis seem possible.  Continue to follow up with your PP provider; or if uncertain about her expertise, see a dermatologist.  Finally, make sure your partner gets checked if that hasn't beend one.

Good luck--  HHH, MD
14 Comments
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Avatar_m_tn
I will take her for a check up as soon as tomorrow, reason why i am worried is because i have been with another girl and she is showing similar symptoms. You are correct they are the inguinal (groin) lymph nodes. I tracked down and spoke with the last person the female that started all this had been with and he was as scared as i am to hear the news (his hands were shaking). Other then the Herpes, are the rest of the diseases/infections that were mentioned curable?  I am halfway relieved to hear a second opinion from an expert (the other half is the worry on the herpes) i always seem to assume the worst in every situation. Thank you for sharing your expertise and helping me get some sleep. I will post the outcome in 3 weeks when the results return
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239123_tn?1267651214
All are curable.

Self judgment of enlarged or inflamed lymph nodes by non-health professionals is notoriously unreliable; most of my patients with such complaints don't have abnormal nodes on examination, and almost everybody can feel their lymph nodes in the groin.  But If yours indeed are inflamed, it strongly suggests folliculitis or other garden variety skin infection (despite your personal conviction otherwise), and not molluscum.  Also, most PP providers would know the difference.

I don't understand what tests are in the works that would take 3 weeks.  HSV diagnostic tests generally take just a few days.  In any case, there is no need to post the results of negative HSV or other STD tests.  There is no chance they will be positive, but if they are, feel free to let us know.
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Avatar_m_tn
Link to picture
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239123_tn?1267651214
I don't look at posted photos.  To my thinking it comes too close to practicing medicine from a distance.  You'll need to see a provider in person.
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Avatar_m_tn
I went for another visit to the doctor and it has been confirmed, its Herpes
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Avatar_n_tn
Just out of curiosity, a couple of questions.

How was it diagnosed that it is herpes, and which type it was? Obviously it wasn't a blood test, or if it was, you probably already had herpes earlier and did not get it 1,5 weeks ago...
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Avatar_m_tn
The person i was with a week and a half ago seems to have a herpes sore on her vaginal lips. Doctor said that it looked just like herpes and nothing else, we are still waiting on the culture no specification if it was either HSV 1 or 2.
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239123_tn?1267651214
Assuming the positive test is a culture, you can take it to the bank, even if the location of your lesions is atypical.  And of course the presence of apparently documented herpes in your partner supports the diagnosis.  In the original question, it would have been helpful to know your partner had a "herpes sore on her vaginal lips. You described her as having symptoms similar to yours, but I interpreted that as folliculitis type symptoms in the pubic area.  Probably it will turn out to be HSV-2, not HSV-1.

Anyway, this is a good reminder to all forum users:  With rare exceptions, the online opinion for a distant forum moderator -- including a highly expert one -- is not as reliable as direct evaluation by a health care provider.

You would do well to read up on genital herpes.  Some excellent online sources are available.  Try the American Social Health Association (www.ashastd.org), Portland Oregon's Westover Heights Clinic (www.westoverheights.com), CDC (www.cdc.gov/std), and my former health department, where I wrote much of the information myself,  (www.metrokc.gov/health/apu/std).
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Avatar_m_tn
Fairly quick, positive for HSV-2 Thank you for all the help and reading material it will help me deal with this life time unwanted companion i will start on suppressive therapy as of tomorrow, Thank you very much
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239123_tn?1267651214
I recommend against starting suppressive therapy this soon.  Experts recommend waiting a few months until you know whether and how frequently you are going to have recurrent outbreaks.  If you happen to have HSV-1, most likely outbreaks will be rare or none at all.  If HSV-2, it could be anywhere from one to 10 times a year.  Further, suppressive therapy probably is not as effective in preventing transmission to new partner in the first few months than it is after several months.

In any case, best wishes.  Congratulations on apparently having a level-headed perspective on the problem.
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Avatar_m_tn
I would like to delete this post, is this possible ?
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Avatar_m_tn
Could any one help me in removing this post ?
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239123_tn?1267651214
A major purpose of the forum is education for all users, not only to respond to questioners' concerns.  Therefore, requests to delete threads usually are denied.  The instructions make it clear that each questioner is responsible to choose a username that assures confidentiality and also to not provide identifying information in the question.

I see nothing in this thread that jeopardizes your identity, which is the only potential justification. But you can use the Contact link to ask MedHelp administration about it.
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University of Washington
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