physical appearance on penis

[bigmonkeycar]

OK, I posted earlier and tried to ask this question in that strand as a second question, so I am reposting...

Again, I had a combined HSV I/II blood test through Labcorps THIRTEEN WEEKS after possible exposure. The test came back negative (as had the same tests at 6 weeks and 9 weeks).

I still have irritations on my penis that I am concerned about. They've come and gone for a few weeks, in different areas. Basically a small bump starts that looks like it has a white core or center to it...if left alone it doesn't hurt and eventually resolves as a small circle looking thing with a "hole" in the center, about the size of a penpoint. If I squeeze the irritation (against better judgement) I'm able to squeeze out a very small, whitish kernel (?), leaving again the circle-shape with the "hole" in the center. These appear on the shaft of my penis, never on the head. If irritated sometimes a very tiny scab forms on the area. Again, when I squeeze the bump and it releases whatever is inside, there is temporary bleeding from the pinhole center.

I guess the question is--does this sound like herpes? I went to a GP and she referred me to a urologist, but I am afraid that by the time I go to that office the irritations will have disappeared. Does herpes look like this? Can you squeeze something out of a herpes sore that looks like whitish gunk, and will the appearance be of a small donut-type circle with a hole missing in the direct center? I'm thinking this could be an infection or a blocked pore...

And of course, the main question is also tied up in the fact of my negative HSV I/II blood test at 13 weeks after possible infection.

Help appreciated--I do want to stop thinking about this, bothering doctors, and requesting bloodtests, but the physical appearance of these is troubling given my earlier concerns.

[H. Hunter Handsfield, M.D.]

Probneurotic (below) is correct that the negative HSV-2 result essentially guarantees that you do not have herpes.  The lesions you describe sound like normal sebaceous glands cysts, and not at all like herpes.  But I cannot make a specific diagnosis on line; you need to get a professional opinion in person.

Good luck--  HHH, MD

[ryn21]

To add, I must clarify something.  Given the correct tests were used, they are conclusive at 12 weeks (labcorp, which i recall the doctor saying, uses the most reliable tests available).

[bigmonkeycar]

thanks guys, and i'm sure the doc will confirm the same info...LabCorps i am still unsure of--whether they use herpesselect or not. the method for I/II combined was chemiluminescence (sp.?), then a different method for reflex to HSVII if the first was positive (which it wasn't). Calling Labcorps to see who manufactures the test is difficult--they don't want to talk to patients, only doctors, and they act like you are asking for military secrets or classified information!

[probneurotic]

Regardless of the "type" of test or where it was performed,  a negative combined test is still reliable.  Problems with the reliability of HerpeSelect vs older tests occur when it is in the positive range or near positive range and there is no distinguishing between type 1 and 2.  A negative combined test by LabCorp, regardless of the type of test used they use, is pretty conclusive.  Don't worry about calling LabCorp to see what type of test was performed.

I agree with the above.  Sebaceous cysts sometimes present like this.  Folliculitis can, but it is usually red and painful with a white (pus) discharge.  Remember that folliculitis and boils are a continuum of bacterial skin infections by staph or strep.  A dermatologist, NOT a urologist, will be able to hash out what the problem is.  Urologists specialize more in the inner workings of the male genital system, not so much the skin infections involoved.

[bigmonkeycar]

Forgot to add--
  in some cases i think these bumps start out as visible, albeit very tiny, white structures that CAN'T be squeezed out..then eventually turn into the previously described things (it doesn't always happen this way, but it's what I've observed in some cases). they occur anywhere on the shaft, not just down low where there are obvious papules and hair follicles..

[probneurotic]

Wait for the doc's response, but...

1) A negetive HSV I/II ab titer at 13 weeks is virtually conclusive that you are not infected with either strain.

2) Herpes does NOT cause this white "kernal" discharge as you describe and does not present with the symptoms you describe, although presentation can very greatly.  Typically, genital herpes presents with tingling and itching followed by GROUPED VESICLES filled with a clearish fluid on a red base.  This follows to a group of shallow  and VERY painful ulcers that will stay from days to weeks, eventually resolving without scar.  

In addition, "squeezing" anything is not typically recommended due to the risk of secondary bacterial infection.

In all, from what you said, you probably don't have herpes.  Wait for the Doctor's reply, he is the definitive source.

[ryn21]

Given your negative test results outside the window period, you dont have herpes.  I recall the doctor saying that Labcorp normally uses highly reliable tests, such as herpeselect, for their standard HSV test.  You can surely rely on your results.  The bumps you describe sound like pimples or folliculitis, possibly even sebaceous cysts.  None of these conditions are dangerous or sexually transmittable.  None are related to STDs in any way.  Whatever they are, quit squeezing them.  You are probably making them more irritated and they will never go away at that rate.  No doctor is going to be able to diagnose the condition over the internet.  What they can tell you for sure is that the HSV results prove that you dont have HSV, period.  

I am no doctor, but folliculitis causes symptoms very similar to what you describe.  Go to http://dermatlas.med.jhmi.edu/derm/  click on index, then click on folliculitis to see illustrations of the condition.  Herpes and other skin conditions are on there as well.

Most importantly, see a Dermatologist to get a diagnosis on what the bumps are.  You should never take the advice of an individual over the net as a definitive diagnosis.  In the meantime, you can forget about herpes; quit worrying!  Good luck.