Weird form of Herpes or not?

[DKwak]

Hello Dr HHH, i really want you to answer this question for me.

Since November 2012 to today i have had 3 occurences detailed below which are strange and puzzling.
When i masturbate i dont use any lube and generally i grind my self against my bed as im lying flat on my belly.
I often masturbate but in those 3 instances when i woke up i found that a small area on the right hand side of my penis head looked inflammed. Each occurence has been in the same area. When i look at it closely it looked like globules of red inflammed and slightly raised areas of skin, some look like thin red lines. But they are definitly not spotty looking. It doesnt hurt and it doesnt itch. The area does feel slightly tender sometimes but very hard to notice. When i proceed to rub it the area gets more inflammed and pronounced and then if i squeeze it i get a little bit of clear liquid coming from the area (i only did this in two of the three times its happened) and when i use tissue to wipe it its got a very light yellow colour to. These globules are more visible after ive had a shower.
Anyway they disappear litterally within the same day - after a few hours even and i get an area of dry skin covering it (not a scab). Those are the first times ive ever noticed it and i'm a person who normally checks his testicles regularly.
I took a video of one of the times i had it and squeezed it for the small liquid to come out. (not painful at all) when i showed it to a GUM clinic staff (the day after the occurence) she felt it may be herpes. But she couldnt explain why as she looked at it that day (which was the next day) she couldnt see anything other then dry skin.

In general my penis head can become quite dry and the skin can peel (especially after the above). If you have email i can show you the before and after on the same day, literally after a few hours.
I have a video of the before and after (same day) and i would be keen for you to see this bizzare episode.
.

[DKwak]

Thanks doc, i wont bother with the test.

I have started using an anti fungal cream and also vaseline (for the dryness). It should be ok.

Thanks a lot for your advice

[H. Hunter Handsfield, M.D.]

In theory, an aborted outbreak could last this way -- development of a red bump that then resolves before developing into a vesicle (blister).  But even this would generally mean total duration at least 3-4 days, never only a few hours or under a day; and it would unusual for this to occur repeatedly.  I remain confident you don't have genital herpes.

Given the information available, I would not recommend an HSV blood test.  Of course you're free to do that, as long as you a) wait until at least 4 months after the last sexual exposure and b) understand the tests aren't perfect and the result could be misleading; look for many threads on this forum that come from users with confusing HSV blood test results.  

[DKwak]

Thanks Dr, my initial view of the whole thing seems to me that it isn't herpes. I will get the blood test and anything else done anyway just to be sure, would you agree that this would be conclusive?

Also i did show the video to the GUM clinic doctor. Before i showed her she didn't see anything wrong with my penis (this was the day after the event). So it was when i showed her that she thought it could be herpes. But she couldn't explain why it had literally gone. I just had dry skin that is all she saw.

And my last question is - even if it was a very mild outbreak (as some people get them and don't even realise it) would it clear up within one day or a few hours? I guess what i am trying to say is what is the likelihood of it being a very very mild outbreak.

I will let you know the results of my tests.

[H. Hunter Handsfield, M.D.]

Welcome to the forum. Thanks for your question.

The news is good:  despite the opinion in the GUM clinic, genital herpes is not a plausible explanation for your penile skin problem.  I can imagine that the appearance may have suggested herpes at the time the GUM clinic staff saw it, but if that person had a complete understanding of the course of events and other details of your description, s/he also would agree herpes is unlikely.  

Herpes outbreaks simply cannot appear and then clear up in a matter of hours or a day or two.  Once a herpes outbreak begins, it generally lasts for 10-14 days.  Herpes outbreaks are not triggered by manual stimulation.  On the other hand, any number of other genital skin anomalies can become more prominent after stimulation.  In addition, herpes does not result in the dry skin and peeling that you describe.

On this forum, we do not examine clinical photos, and I cannot examine your video.  In our view, this comes too close to practicing medicine from afar, which we stricly avoid; it's not the role of an online medical advice service to supplant direct clinical care.  However, you might consider showing it to your GUM clinicician for his or her opinion about it.

My guess is that you have some sort of garden variety genital dermatosis (maybe lichen planus? or eczema? psoriasis?) that becomes more prominent with physical stimulation.  I see no serious likelihood of genital herpes.

I hope this has helped.  Best wishes--  HHH, MD