HSV Autoinoculation or Folliculities?

[faksnima]

I have a question regarding autoinoculation of a primary HSV oral outbreak to genital. I made out with a girl who confirmed she had a prior history of cold sores. We made out on a Tuesday (day 1) and again that Friday (4). That next Thursday (10) I had dental work done which involved x-rays and cleaning. That following Sunday (13) or Monday (14) I noticed that the gland under my left jaw, where the neck and jaw meet became inflamed. I made an appointment with the doctor who assured me this was probably a salivary gland infection due to the recent dental work (which was quite painful and included bleeding gums). By Wednesday (16) I had become fevered, sore throat, and had an ear ache. Thursday (17) I had a red bump on my lower left lip with a small pit in the middle and by late Friday/Saturday (18/19) I had another bump on my lower right lip. These bumps started out red and inflamed and crusted over. They were not clusters and seemed to be elevated. In fact four weeks later I still have a small bump where the sore was. They did break and scab over repeatedly which is typical of cold sores, as I understand. There was no tingling prior to the outbreak but some during and after. Anyways around Wednesday/Thursday (16/17) I noticed a tender red bump near the base of my shaft. In my sickly state I wasn't sure, but I can remember seeing a hair follicule either near or coming out of bump. I squeezed it, but it proved to be quite painful. It scabbed over the next day, which I picked at and then and then disappeared. I am a tad bit of a hypochondriac and am worried I autoinoculated myself. I do have eczema in that area (scrotum and base of the penis) which results in frequent severe itching. I'm unsure if it was severely itching at that point. I have had scabbing in that area previously, which I have attributed to chafing. The only relevant sexual experience I have ever had was an unprotected oral sex encounter ~2.5 years ago and I do not recall contracting anything at that point.

[Bhupinder Kaur, MD]

Hello,
From your symptoms definitely herpes infection needs to be ruled out since there is a history of unprotected intercourse. The only way of ruling it out is by getting yourself tested for genital herpes. Laboratory tests include: culture of the virus, direct fluorescent antibody (DFA) studies to detect virus, skin biopsy, and polymerase chain reaction (PCR) to test for presence of viral DNA. I sincerely advise you to consult a dermatologist and get it ruled out.

It is very difficult to precisely confirm a diagnosis without examination and investigations and the answer is based on the medical information provided. For exact diagnosis, you are requested to consult your dermatologist. I sincerely hope that helps. Take care and please do keep me posted on how you are doing.

[faksnima]

I forgot to mention gum inflammation during the ordeal.