herpatic inner thigh

[vk080301]

Hi,

I am in search of some real facts, as I can't seem to get a factual answer regarding the following:

About 2 months ago I had some intimate contact with a person (NO SEX just some thigh-to-thigh contact during cuddling - my underwear was off and hers was on). Few days later I developed some bumps on my inner thigh and one bump in the pubic hair area. The doctor said it is definately herpatic......but said that because it is not on the penis head or penis shaft, technically this is not genital herpes and that I have nothing to worry and that there is no risk of transmitting to future partners. However, when I go on the internet they speak of shedding and that this can be a form of transmitting. I spoke to my doctor and he told me the following which I want some confirmation on:

1) Shedding only happens from a mucous membrane, and because I did not have it on the penis shaft or head, this is not an issue. Can you confirm this?

2) If the virus is only transmitted through a mucous membrane how did I get this on my inner thigh?? Is it possible to get it from skin to skin contact, where there is no mucous membrane, but because there is no mucous membrane where I was infected, it will not shed??

3) Overall, I'm trying to solve the inconsistencies between what I read on the internet and what my doctor told me. He assured me that I have to take no precautions and that there is no risk of me transmitting this. Is this accurate given the facts of my situation??


Please be specific to the facts of my situation, and ask any questions if you need.

Thanks

[Edward W Hook, MD]

Yoru qeustons are lall based on the concnept that this is HSV.. I doubt the basic premise.

1.  HSV can recur and cause asymptomatic shedding at any site were the nerves which serve the orignal site of infection go.  There is a chance that nerves going to parts of the inner thigh also go to the genitals and therefore IF this was HIV, it might lead to transmssion.
2.  No, alcohol wipes and local disinfectants would have no impact.
3.  no

Please, no more "what if" questions unless we know this is HSV

EWH

[vk080301]

Quick follow-up on your above comment:

1) So if it is HSV and it only sheds from original site of infection, and because that was NOT on the penis for me....does that mean as long as my inner thigh (site of original infection) does not have contact with anybody else during future intercourse, there is no chance of transmission?

2) Would using something like an alcohol wipe at the original site of infection kill any live virus and therefore also decrease or eliminate any chance of infection.

3) I  do get some tingling in the testicles; even though that was not the original site of infection. Does that mean the virus is also shedding from the testicles area?

Thanks

[Edward W Hook, MD]

The interaction and location you  describe represents an unlikely scenario for HSV transmission.  Thus, even before I answer your specific questions, I have one for you.  Was your diagnosis of HSV made by culture or PCR test performed on a swab from the lesion.  If not, you cannot be sure that you have herpes.  While we used to think that we health care providers could diagnose HSV on the basis of appearance, we now know that about 25% of clinical diagnoses of HSV turn out to be wrong.  Having said that, I will do my best to answer your questions but in general, many of these questions and information about herpes can be obtained by accessing excellent informational web sites such as the one run by the American Social Health Association (disclosure, Dr. Handsfield and I are both on the Board of Directors of ASHA).  Now, for your questions:

1.  Shedding of HSV can occur from any site of infection, even if lesions are not present.  Infections typically occur on skin and/or mucous membranes and are certainly not limited to mucous membranes.

2.  We see HSV lesions at a variety of skin locations including the thigh.  they are less common than at the genital site but this does happen.

3.  If this is HSV, spread through contact with the site infected on your can occur and can infect others.  At the same time however, most exposures to partners with HSV do not lead to transmission.


Hoe these comments help.  EWH