Herpes or Shingles...on knee

[Tigana]

I was just diagnosed with shingles. THe location is on my knee and is a small outbreak (less than 10 lesions). I was just told that it might be Herpes simplex rather than Zoster. I do have HSV1 and asked if I could have transmitted it to my knee, I was told no, but that would mean a new infection of HSV????. I do not know if I have HSV2. I know that HSV can occur anywhere on the body. If it is HSV2 on my knee, does this mean that, if I have outbreaks again, they will be at this same location (like I always have cold sores on my lip)? I worry about shedding the virus genitally if it is HSV2. Is it possible to shed HSV2 even if the site is not genital?

[gracefromHHP]

you can have ob's anywhere below the waist.  Knees, thighs and sometimes even feet can be areas of lesions from hsv.  It's all the sacral nerve ganglia.

no, oral herpes infects the trigeminal nerve ganglia. It won't travel down the spinal cord to the genitals to shed from there.

[Tigana]

I am wondering about genital transmission if I have is HSV2 in a nongenital site. Does not the virus reside in ganglion which serve specific pathways? If the virus is residing in a site not serving the genital region (e.g. lower extremities) how can it travel along nerves to the genitals to cause breakouts or shedding there? Wouldn't the same logic apply to having HSV1 on mouth and the shedding of virus genitally? This would mean that all those people (80%) of population positive for HSV1 would be spreading genital herpes.....

[gracefromHHP]

it's unfortunate that your provider dropped the ball like this and didn't do a lesion culture :(  It really is the best way to see if it's hsv or hzv going on.  

at this point, you and your partner should both get type specific herpes igg blood testing to see who has what and go from there. If this is hsv, you do also have it genitally so it is important to know who has what and not just take the wait and see approach. Studies have shown that when you have non-genital lesions, you also shed the virus from the entire anogenital area both with obvious symptoms as well as periodically in between so it is important to get better answers than you have so far.  

grace

[Tigana]

No... they didn't test the lesions. The sores didn't open so there was no fluid to test..... Valtrex does seem to be helping quite a bit, so I assume that the diagnosis of a viral cause -- whether zoster or simplex-- is correct. I could have blood work for antibodies done. What I was told was that if they return to this site, they are likely from simplex. If they don't return, they are likely zoster. I was also told not to worry about genital transmission, even if it is simplex, given the location.... What is your take? Should I stop freaking out?

[petal130]

Did they not do a swab/culture of the lesions? A visual diagnosis is poor medicine unfortunately. No way of knowing unless it's cultured. You can have herpes on other body parts besides the typical oral/genital area, but the knee is thicker skin so it would be uncommon.

Did you have any testing done?