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Avatar universal

Recurrant groin folliculitis. NOT HSV2

Hi there,

So for the past 6-7 months I've been suffering from a recurrent infection in my pubic region.  It usually starts with a red, very swollen patch 3-5mm across, asymmetrical in shape.  It's not painful, though it can itch on occasion. The hair follicles swell and eventually harden and the skin around the hair peels back leaving an abscess which heals in about a week or so.  The swelling reduces dramatically but for the affected follicles, which remain raised and swollen.  They are not painful, and produce no visible discharge, blood or pus.  Occasionally I'll see what look like tiny whiteheads, but vanish after a few hours leaving flaking skin.

I've applied Bactroban ointment which seems to hasten healing, tea tree oil, which does apparently nothing, and antifungal cream which just burned a lot.  Neosporin actually may have made the infection worse, as the first time I had a lesion I applied Neosporin to the area, only to have it spread within a few days.

To make a long story short, I've undergone repeat testing for Herpes though my genitals have (thankfully) never been affected in any way.  I've always tested negative for HSV1, though early tests for HSV2 were indeterminate.  My most recent test was negative for HSV2 using an IgG blood test (results were in normal range).

But I still keep getting these breakouts!  They're quite unseemly and I've had at least five in the past 6 months, usually around the same area.  I want to know what the cause would be, since it doesn't appear to be staph or bacterial (no pus or pimple-like boils) and not herpic (no pain, obvious blisters, ooze or crusting, outbreaks are more frequent than generally associated with HSV and negative testing).  Is it contagious?  Should I be concerned?  Can it be prevented?
3 Responses
563773 tn?1374250139
In the absence of STD’s, it can be due to fungal infection, dermatitis (atopic, contact, allergic), heat rash or excessive sweating causing sweat dermatitis.

You may try calamine lotion. You should also maintain hygiene and try to keep the area clean and dry, wear loose-fitting cotton clothing. Also use an antibacterial soap or mild soap like dove.Avoid deodorant / cosmetics. You can also use a barrier cream with zinc oxide paste or petroleum jelly applied directly to wet skin after bathing.

If the symptoms persist then it will be best to get it evaluated from a dermatologist and get a biopsy skin done.

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 doctor. I sincerely hope that helps. Take care and please do keep me posted on how you are doing.

Avatar universal
Thank you doctor!  I saw my dermatologist who declined to perform a biopsy or offer a diagnosis.  He said that outside of HSV, he didn't know what could be causing recurrent symptoms.  Since my test was negative, he also didn't prescribe treatment.  He offered low dose Valtrex (again, despite the negative test) or antibiotics (which I've already been using).  Frustrating, to say the least.  

Are there other forms of viral folliculitis besides HSV?  Something that doesn't produce pus, but still abscesses?
Avatar universal
Just an update, doctor.  I've seen a new, highly-recommended dermatologist, who has ruled out bacterial infection through blood swabs.  He also agrees with my PCP and the MedHelp experts that my IgG test results seem to rule out HSV as a cause.  He also thinks fungal infection highly unlikely.

Are there any other viral conditions that can cause skin abcesesses/necrosis?  I still have no pain, oozing or itching, but I've had a lesion for a full 3 weeks now that shows no sign of healing.  I had two smaller ones which healed up more than a week ago.  Are my symptoms indicative of anything specific?
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