is this probably or probably not herpes?

[anonymous1111]

I am a 32 year old healthy male.  I recently saw a legion on my scrotum and no other place.  I have read that it is very uncommon for a first reaction to take place only on the scrotum.  In addition, I did not notice any blister or pimples.  THe legion was red.  My dermatologist does not think it is herpes and gave me a steroid-based cream to get rid of the skin irritation.  In about 4 days, it is almost totally gone and never really hurt at all.  I read that a steriod-based cream would be bad for herpes.  Thus, is the fact that the cream helped a good sign? Finally, thinking back at least 3 years, I cannot think of anyone I had sex with that would have had herpes.  Is it unlikely a first outbreak would be longer then 3-4 years from infection?  My dermatologist took a shwab of the legion so we will see, but in the meantime, please advise.  It really seems out of the blue and I am scarred and confused.  I am hoping it is simply a case of irritated skin or a bacterial infection.

[H. Hunter Handsfield, M.D.]

You are correct that herpes lesions are pretty uncommon on the scrotum, both for first outbreaks and recurrences.  But even more important, if a dermatologist says the lesion doesn't look like herpes, you can rely on that - certainly that's a much more reliable judgment than I can make just by written descritpion.  Finally, the quick response to steroid cream indeed supports the non-herpes diagnosis.

I suppose you are concerned about herpes simply because it's a genital lesion.  But almost every one of the hundreds of things that can cause skin rashes sometimes occurs in the genital area.

Bottom line:  It sounds like you have a knowledgeable dermatolgist.  Follow his advice.

Regards--  HHH, MD

[anonymous1111]

One more thing, I also have no other symptoms, such as flu-like symptoms, back-ache or burning urination, etc.

[ryn21]

I doubt its herpes.  I am almost positive that its probably not herpes, as im sure the doctor will tell you as well.  To add, the fact that an over the counter steroid cream cleared it up in 4 days should tell you that its more likely an irritation or possibly a fungal infection.  I wouldnt worry, but wait for Doctor Handsfield to reply.