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STDs (Expert Forum)
mis-diagnosed?
Answered by
University of Washington
Seattle - WA
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IMPORTANT
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Some of the most common types of questions concern the risk of HIV or STD after a particular sexual exposure, and about symptoms that might or might not be due to HIV. If your question is along these lines, please visit the HIV Prevention and Safe Sex Forum.
This forum is limited to questions about STDs other than HIV/AIDS. For questions about HIV prevention, or if you have general questions about safe sex (e.g., condoms, how to protect yourself from HIV and STDs), please visit the HIV Prevention and Safe Sex Forum
Some of the most common types of questions concern the risk of HIV or STD after a particular sexual exposure, and about symptoms that might or might not be due to HIV. If your question is along these lines, please visit the HIV Prevention and Safe Sex Forum.
mis-diagnosed?
by mullosk, Oct 25, 2005 12:00AM
Hello again Doctor,
First off, thank you for all of your help recently. I've been going through some tough times and you've seem very logical and realistic about things. So here goes another question. I am a 31 year old male. As I wrote to you a few days ago, I have had oral herpes since I was 19. I just moved to a new city and today recieved my past medical history files from my former doctor. I was looking through it and something caught my eye. When I was 23 I went to the doctor because I had flaky skin on my scrotum and my inner groin area. In my medical file my doctor stated that my genitalia was "very erythematous with flaky skin on the scrotom and in his inner groin area indicative of a fungal infection." He diagnosised me with fungal infection (Tinea Cruris) and gave me some Lotrimin and Hydrocorisone. A month later the flaky, peeling skin did not improve and in fact got a bit worse after using Lotrimin and Hydrocorisone. I went back to the doctor and he reexamined me stating in my file "exam reveals intense erythema on the entire scrotum as well as in the groin intertriginous folds. There are some satellite lesions. There is some scale." He then diagnosised me with Candida and gave me a perscription for Nizoral Cream. I applied this cream and the problem cleared right up. I had no problems after that. I looked up Candida on line and it seems like it is mostly a woman's condition. Can men get a Candida condition as well? Also, I looked up the term erythema on line and it seems to be a medical term for dry, red flaky skin. However I did notice that "Erythema multiforme" is a condition that is 90% of the time is caused by the herpes virus. No where on my record does it say I have "erythema multiform" or "herpes". My doctor was using the term erythema to discribe the symtoms of by groin area. So can a man have erythematous symtoms on his penis with out having herpes? Is there a possibility that he may have mis-diagnosed me? I recall that I was not very sexually active at the time and recall only peeling, dry skin when this happened. I never had any blisters of any sorts. You should also know that I did have peeling skin on my penis once again about 5 years after it happened and I put a little lotion on it and it was gone. Is Candidi something that can come back? I've tested postive for HSV-1 which was no surprise since I've had pretty servere outbreak of cold sores in my mouth when I was 19. I tested negative for HSV-2 recently. I just hope i wasn't mis-doignosed and I have had gential herpes this whole time. I just wanted to get your take on all of these as I am probably just mis-interpreting some medical terms. Thank you again for you advise.
First off, thank you for all of your help recently. I've been going through some tough times and you've seem very logical and realistic about things. So here goes another question. I am a 31 year old male. As I wrote to you a few days ago, I have had oral herpes since I was 19. I just moved to a new city and today recieved my past medical history files from my former doctor. I was looking through it and something caught my eye. When I was 23 I went to the doctor because I had flaky skin on my scrotum and my inner groin area. In my medical file my doctor stated that my genitalia was "very erythematous with flaky skin on the scrotom and in his inner groin area indicative of a fungal infection." He diagnosised me with fungal infection (Tinea Cruris) and gave me some Lotrimin and Hydrocorisone. A month later the flaky, peeling skin did not improve and in fact got a bit worse after using Lotrimin and Hydrocorisone. I went back to the doctor and he reexamined me stating in my file "exam reveals intense erythema on the entire scrotum as well as in the groin intertriginous folds. There are some satellite lesions. There is some scale." He then diagnosised me with Candida and gave me a perscription for Nizoral Cream. I applied this cream and the problem cleared right up. I had no problems after that. I looked up Candida on line and it seems like it is mostly a woman's condition. Can men get a Candida condition as well? Also, I looked up the term erythema on line and it seems to be a medical term for dry, red flaky skin. However I did notice that "Erythema multiforme" is a condition that is 90% of the time is caused by the herpes virus. No where on my record does it say I have "erythema multiform" or "herpes". My doctor was using the term erythema to discribe the symtoms of by groin area. So can a man have erythematous symtoms on his penis with out having herpes? Is there a possibility that he may have mis-diagnosed me? I recall that I was not very sexually active at the time and recall only peeling, dry skin when this happened. I never had any blisters of any sorts. You should also know that I did have peeling skin on my penis once again about 5 years after it happened and I put a little lotion on it and it was gone. Is Candidi something that can come back? I've tested postive for HSV-1 which was no surprise since I've had pretty servere outbreak of cold sores in my mouth when I was 19. I tested negative for HSV-2 recently. I just hope i wasn't mis-doignosed and I have had gential herpes this whole time. I just wanted to get your take on all of these as I am probably just mis-interpreting some medical terms. Thank you again for you advise.
Doctor's Answer
by H. Hunter Handsfield, M.D., Oct 25, 2005 12:00AM
, Oct 25, 2005 12:00AM
I have nothing to add to my previous responses, and you have seen health care provider who--based on your description--seem pretty knowledgeable. An online doc cannot compete in diagnostic accuracy with providers who have actually examined someone.
I cannot comment on the possibilty of erythema multiforme. However, most cases of EM are triggered by HSV infecttions. With your negative HSV-2 test results, clearly your genital symptoms are not due to that infection. Whether your chronic HSV-1 infection is triggering EM, however, I cannot say. But herpes itself is not causing any of the symptoms you describe. I also cannot comment further on the possibility of other infections, such as candida or other fungus infections.
You need to rely on the advice of your own doctors. I won't have any further comments.
HHH, MD
I cannot comment on the possibilty of erythema multiforme. However, most cases of EM are triggered by HSV infecttions. With your negative HSV-2 test results, clearly your genital symptoms are not due to that infection. Whether your chronic HSV-1 infection is triggering EM, however, I cannot say. But herpes itself is not causing any of the symptoms you describe. I also cannot comment further on the possibility of other infections, such as candida or other fungus infections.
You need to rely on the advice of your own doctors. I won't have any further comments.
HHH, MD
It is a total coincidence that I just recieved my past medical records yesterday and recalled the dryed skin condition I had almost 10 years ago. When I looked up some of the medical terms in my exam I decided to e-mail you to help me clarify just what problem I did have. To be honest with you it scared me when I typed in "erythema multiform" in an on-line medical dictionary and the word "herpes" appeared. Even though my doctor nor my exam report never mentioned "herpes" or "erythema multiform" i was nonetheless startled by this. Although, he did use the term "erythema" to discribe by symtoms. I hope it's not to much to ask your medical advise, not a diagnosis, on the following:
Can Candida appear on a mans penis?
What exactly is Candida?
Can a man have Candida with erythematous like symtoms?
Can a man have erythematous symtoms on his penis with out having genital herpes (either type 1 or 2) herpes?
Can oral herpes trigger erythema multiform in the genital region?
If not, is there a possibility I had asymtomatic hsv-1 genital herpes and not known about it and thus it triggering a possible "erythema multiform"
What exactly is "erythema multiform"? Can it come back?
Is it rare for someone with herpes to get "erythema multiform"?
Dr, I'm honetly not a hypercondriact or someone just trying to get free medical advise. My former doctor has since moved on and I can not ask him about his diagnosis. I do plan on asking my new doctor about this but since I won't be able to see him for a while I thought since you were very helpful last time I would ask you as well.
I'm really trying to get a handle on everything right now and just want to know exactly what IS going on what HAS gone on with my body as I think it is important when moving on with life and future relationships.
Best Regards.
Good luck.
HHH, MD
Can Candida appear on a mans penis?
What exactly is Candida?
Can a man have Candida with erythematous like symtoms?
Can a man have erythematous symtoms on his penis with out having genital herpes (either type 1 or 2) herpes?
Can oral herpes trigger erythema multiform in the genital region?
What exactly is "erythema