small red spots on glans(glands)

Background: 5 or so months ago i was seeing the same girl for a lengthy period of time, we had unprotected sex on various occasions. One day i noticed some discomfort while having sex (condom WAS on this time) and when removed small red spots (not blister like with herpes) were found on the head of the penis, and very few on the interior of the foreskin.
I panicked and immediately had tests done.
Test for Herpes Simples 1&2, Bacteria, Chlamydia ALL came back negative to my releif.
THe spots on first occurence took about 2 weeks to completely go away. On occasion i would think spots were developping again only to have nothing there the next day. 5 months later and there seems to be these same spots again. They do not itch, do not blister, do not produce any discharge if rubbed the head of the penis around these spots seems to want to 'shed' small amount of tissue kinda peels away (VERY MINUTE AMOUNT - seems almost like dry skin around the spots). I went back to the emerg. to have looked at physician in ER looked at previous tests and mentioned that from what he saw that day doing a swab would prove a waste as there was no discharge or open wound type problem to swab. The spots have not gone away yet all though they do seem to be heading in that direction. It's very stressful having them there as if they are not an STD what are they? and are they harmful to anyone else? If a picture is required, i have a cam and would gladly do so, for better consultation.

[H. Hunter Handsfield, M.D.]

I doubt it is  harmful.  It doesn't really sound like herpes, but that's still my greatest concern from an STD standpoint, because all kinds of atypical lesions can be due to that disease,  blood tests for HSV don't become positive for a few weeks.  (You don't say how long it was between onset of symptoms and when you had the HSV tests.)  But I'm actually more concerned about dermatitis that started as an allergic reaction to lubricant (or spermicide) in the condom, or to latex itself; or perhaps psoriasis.

If the rash fades, I would just disregard it--although if you want to be even more certain it isn't herpes, get another blood test.  But make sure it's the right test; the only one that is accurate is the HerpeSelect test; be sure your health care provider requests it by name.  And if the rash persists, see a dermatologist.

In the meantime, don't worry overmuch about it; doesn't sound serious.

Best wishes--   HHH, MD

[jogging_monkey]

Thanks, on another note I've failed to add that i got the spots and was tested no more than 2 days later. The tests were sent away by the Hospital (not sure if its HerpesSelect) and came back negative 3 weeks later.

As well i failed to mention although i dont beleive it has to do with anything STD related that i have had pretty ridiculous itching around the anus... But this was far prior to any penile signs of these spots and the itching i think only continues due to my incessant urge to scratch at it...

hope this is a little more helpful. The tests were conducted 5 months ago.

[H. Hunter Handsfield, M.D.]

I don't have further thoughts about the penile lesions.

Pruritus ani (Latin for itchy anus) has lots of causes.  Although probably unrelated to your other problem, one potential cause is herpes--and most docs don't even think of it.  Anal-area outbreaks are pretty common in people with genital herpes, moreso in women but also in men (both gay and straight--anal recurrences also occur in straight men with no anal sexual exposure).  But herpes isn't the best bet; most cases have no clear cause and as you suspect, this probably is entirely unrelated to the other problem.  You might try some over-the-counter steroid cream (i.e., hydrocortisone) which often give dramatic relief.  If that doesn't help, see a health care provider.

Best wishes--   HHH, MD