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STDs (Expert Forum)
What is it?
Answered by
University of Washington
Seattle - WA
Welcome to the STD Forum, which 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.
What is it?
by 123abc_, Sep 19, 2006 12:00AM
About three months ago, I had an encounter I greatly regret. I received unprotected oral sex from a female escort for about five minutes. This is the only encounter outside of my 15 year marriage.
I have not really had any symptoms for STDs, but one issue has caused some mild concern.
I have a very mild case of psoriasis that affects me in the genitals (scrotum, anal area). These areas are red quite often and cause itching. Also, I have jock itch often as I exercise a lot and sweat a lot. The jock itch usually affects me in the inner thigh area and butt crack lining. Usually, I use clotramizol or lamisil which seems to work just fine. I also have minor hemorrhoids.
The reason I am writing is because recently I had a jock itch-like rash on my buttocks. The buttock rash itched like crazy, especially at night and became highly inflamed, almost welp like and covered nearly the entire bottom portion of my right butt cheek. It also bled a little. I wouldn’t say it was blister-like though. I believe it was in conjunction with a jock itch rash in my inner thigh and butt crack. When I have an out break in these areas, the inner thigh and butt crack lining area have pretty defined borders. The rash on the buttocks also seemed to have raised borders, but in many different areas, covering a large portion of the right lower butt cheek and anal lining. The swelling of the inflamed areas would subside in the morning when I didn't itch as much. I used Lamisil and the problem seemed to resolve after about a week. However, brown spots/blotches remain on my buttocks to this day, similar to the color of my inner thigh/groin area.
I believe I had the brown spots before my oral encounter and that I have had similar rashes before on my buttocks, but I am just trying to be certain.
I went to a dermatologist. My wife visits her also, so I couldn’t really tell her about my herpes concern. She looked at my brown spots and said she couldn’t tell for certain since the problem had resolved but that it was probably a fungal infection since I seemed to believe Lamisil cleared it up. She said that jock itch could spread to the buttocks and that psoriasis is also very common on the buttocks. She said it takes a really long time for the brown spots to go away, sometimes more than a year and to not worry about it.
As I mentioned, I believe Lamisil clears it up, but since herpes resolves by itself as well, I am concerned that it is this reason and not the Lamisil that is curing it.
Does any of this sound like an initial herpes outbreak?
I strongly believe it is not. My reasoning is, it is not at the point of contact (there was no contact anywhere else but the oral sex to my penis), herpes does not leave marks (brown blotches has been there for months), I have other conditions that explain it much better (psoriasis, jock itch). Is this logical?
I would just like to get over this hurdle and move on with my life.
I have not really had any symptoms for STDs, but one issue has caused some mild concern.
I have a very mild case of psoriasis that affects me in the genitals (scrotum, anal area). These areas are red quite often and cause itching. Also, I have jock itch often as I exercise a lot and sweat a lot. The jock itch usually affects me in the inner thigh area and butt crack lining. Usually, I use clotramizol or lamisil which seems to work just fine. I also have minor hemorrhoids.
The reason I am writing is because recently I had a jock itch-like rash on my buttocks. The buttock rash itched like crazy, especially at night and became highly inflamed, almost welp like and covered nearly the entire bottom portion of my right butt cheek. It also bled a little. I wouldn’t say it was blister-like though. I believe it was in conjunction with a jock itch rash in my inner thigh and butt crack. When I have an out break in these areas, the inner thigh and butt crack lining area have pretty defined borders. The rash on the buttocks also seemed to have raised borders, but in many different areas, covering a large portion of the right lower butt cheek and anal lining. The swelling of the inflamed areas would subside in the morning when I didn't itch as much. I used Lamisil and the problem seemed to resolve after about a week. However, brown spots/blotches remain on my buttocks to this day, similar to the color of my inner thigh/groin area.
I believe I had the brown spots before my oral encounter and that I have had similar rashes before on my buttocks, but I am just trying to be certain.
I went to a dermatologist. My wife visits her also, so I couldn’t really tell her about my herpes concern. She looked at my brown spots and said she couldn’t tell for certain since the problem had resolved but that it was probably a fungal infection since I seemed to believe Lamisil cleared it up. She said that jock itch could spread to the buttocks and that psoriasis is also very common on the buttocks. She said it takes a really long time for the brown spots to go away, sometimes more than a year and to not worry about it.
As I mentioned, I believe Lamisil clears it up, but since herpes resolves by itself as well, I am concerned that it is this reason and not the Lamisil that is curing it.
Does any of this sound like an initial herpes outbreak?
I strongly believe it is not. My reasoning is, it is not at the point of contact (there was no contact anywhere else but the oral sex to my penis), herpes does not leave marks (brown blotches has been there for months), I have other conditions that explain it much better (psoriasis, jock itch). Is this logical?
I would just like to get over this hurdle and move on with my life.
Doctor's Answer
by H. Hunter Handsfield, M.D., Sep 19, 2006 12:00AM
, Sep 19, 2006 12:00AM
You're clearly experiencing a left brain/right brain battle: rational understanding that you don't have herpes versus the more emotional reaction. Your left brain is right. There is nothing in your description that suggests herpes, either by location or the nature of the rash itself. Even without your doctor being primed to the possbility, any dermatologist would readily recognize herpes.
And on top of all this, the risk of getting herpes from a single episode of receiving oral sex is very low; and if you did, the problem would have been limited to the penis itself.
I hope this helps. Best wishes--
HHH, MD
And on top of all this, the risk of getting herpes from a single episode of receiving oral sex is very low; and if you did, the problem would have been limited to the penis itself.
I hope this helps. Best wishes--
HHH, MD
Just one clarification. The condition had resolved by the time I saw the dermatologist. All that was left were the brown spots. I only bring this up because you said the dermatologist would have recognized herpes.
Am I repeating something you already understood? Just a quick answer would be greatly appreciated.