STDs Expert Forum
groin rash - herpes?
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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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groin rash - herpes?

I've been doing a lot of research on this forum but unfortunately I never saw a doctor after I developed the rash during the "sweet spot" for hsv exposure..I just assumed it was nothing but now the internet has me freaked out!

I'm male and hooked up with an old aquantance unprotected.

about 11 days later i developed a rash on my right groin that manifested itself in 3 distinct areas. First, I know the difficutly of diagnosing a rash over the internet (duh!) but i thougth more or less you could offer your expert opinion on liklihood since you have seen may lesions in your time.

It first started as an itch and developed into 1) a thin raised linear red rash in between my thigh where it meets the groin. It was a little moist and burned just a little. 2) a similar linear horizonal line red rash, didn't seem raised, on the right side located on the front where the pubic area meets the shaft it was very difficult to see and located in the strip where there is litle to hair. Lastly, a few scattered red tiny pimples on the front right groin above and to the right of the pubic hair (did not appear in a cluster)

Overall, the presentaiton was very hard to see. That being said, it cleared up in about 3 days on its own. Not sure if there was any scabbing.  I also took antibiotics for an unrelated sinus affection right before my encounter - not sure if this is a potential cause.

Thanks for what you do.
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Welcome to the STD forum.  I'll try to help.

First, if you don't mind a general observation about your opening comment, i.e. researching your symptoms online without seeing a doctor.  Of course that's why we have health care providers!  In the long run, professional care is the way to learn the cause of unexplained symptoms, unless the answer becomes very obvious with the very first online search.  And as you have also learned, the less obvious the diagnosis from the initial inquiry, the greater the chance that continued searching will only find information that leads to freaking out.  So before I read anything else, most likely you don't have herpes (if you did, you would have quickly found that your symptoms were a perfect match for that diagnosis); most likely the diagnosis is not serious; and most likely I'm going to end up telling you to see a health professional about it.

Now I have read the body of your question.  Guess what?

First, it's good to see you have already learned the lesson above, about searching for a diagnosis on the internet!

Herpes rarely causes rash in the groin -- and that's especially true for the initial episode.  Recurrent herpes can occur anywhere in the "boxer shorts" area, but the initial infection almost always occurs at the sites of maximum friction during sex -- i.e. the penis, vaginal opening, labia minor, anus, etc.  That's because the virus has to be massged into the tissues, often with microscopic abrasion.  Equally important, your description doesn't sound like herpes.  And still more evidence against herpes:  an initial HSV infection cannot clear up in under 10-14 days, sometimes as long as 3-4 weeks.  Three days is impossible.  Finally, "the presentaiton was very hard to see" suggest you might just be looking too closely, i.e. that nothing is wrong at all.

As to other causes, I doubt it is an antibiotic-related rash, which usually would be body-wide and not so localized.  In the groin, things like heat rash, jock itch, and superfical minor bacterial infections all sound possible.  You might have folliculitis.

Bottom line:  I see no concern at all about herpes and doubt this has anything at all to do with your recent sexual encounter.  See a health care provider if the problem persists or recurs.  But in the meantime, I really wouldn't worry about it.

Good luck--  HHH, MD
5 Comments
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Avatar_m_tn
Hi HHH!

I went ahead and took an igg test at 7.5 weeks since the exposure since I've never been tested. Thankfully negative. I have had other symptoms but they seem to be atypical. Two weeks post exposure had sore muscles in my legs and calves but no flu. Also, my legs sometimes feel like they are asleep or restless. Is this tingling?

1) with a negative test at 7.5 days and atypical symptoms due you reccomend another test? Also I need to revise the original timeline - i looked back at the calendar ..the rash appeared two weeks after exposure so it fell slightly out of the sweet spot

2) my test was a type specific at quest. My levels were well below the cutoff according to my doc but not sure of the value. Would it have been higher if I was currenly infected and still developing antibodies?

Thanks for all you do!!! I know you have a busy life
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239123_tn?1267651214
Your onset was not "slightly" out of the "sweet spot".  It was well out.  Probably 80-90% of people with new HSV have symptoms within 5 days of exposure.  The additional symptoms you describe do not suggest herpes.

1) As far as I'm concerned, you really didn't need HSV testing at all.  Since most (75-80%) people with new HSV-2 infections have positive results by 6-7 weeks, your negative result at 7.5 weeks is additional proof against herpes. But if you want still higher assurance, you could have another test at 12+ weeks.

2) Any level below the negative cut-off is 100% negative.  There is no difference at all in the meaning of results of, say, 0.2, 0.6, or 0.85 (with cut-off at 0.9).

Time to move on, with no worries about herpes from your recent exposure.  That should do it for this thread. Thanks for the thanks.
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Avatar_m_tn
Hey doc -

I have one more point of clarification. I found the herpes aasha orginization online and the believe the primary outbreak to occur between 2 and 3 weeks. I've also read some conflicting info on how long it could last - meaning a few days is possible. Obviosly these sources probably don't have the years of experience in the field that u do  but I was curiuos what you thought.
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239123_tn?1267651214
I suggest you stop reading about herpes.  The manifestations are highly variable.  Therefore, you will find lots of descriptions that can convinced anxious persons believe they have it.  You do not.  Therefore, there is no point in continuing to read about atypical presentations.

That's the last comment on this thread.
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