Possible Genital HSV-1

[GaMan]

I have had this really minor rash on foreskin a few times in the last 4-5 years (say once per year) with the most recent event just last week. Rash always goes away within a week or less and always occurs in warmer months. No blisters, pain, drainage, raised bumps, or anything else and symptoms look like a few tiny pinhead sized scabs.  I had seen a dermatologist and personal care physician (PCP) 10-12 yrs ago about an area of split skin up on the penis shaft that wouldn't heal for a couple of  months and they said was either jock itch or exzema but they both were confident it wasn't herpes based on visual alone (no cultures). Tinactin seemed to clear it up and I didn't have any issues for a few years until the rash started several years ago up on the foreskin or head of penis. Note that I have not been sexually active since seeing those two doctors.

Just went to a different PCP Dr. little over a week ago about a recurrence of rash and he thought it was herpes based on a visual only. I had all STD tests done and was positive for HSV-1 (4.67 IGG antibodies >0.9; IGM antibodies normal) but negative for HSV-2 and all other STDS. However, I already knew I would test positive for HSV-1 as I've had cold sores since 1986.  I asked Dr. to do a swab when I was there but he said it was almost healed and probably wouldn't give any meaninful results. I went to the dermatologist I originally went to 10-12 yrs ago and discussed all the info I've posted here with him.  He did not think it was herpes based on my history but rash had already cleared up.

Had a few questions:
1. Is there any other test(s) that might tell me more in the event I never had another rash develope?
2. I feel confident I had the HSV-1 virus (cold sore) before the potential of being exposed to it in the genital area.
    Don't antibodies lower the risk of acquiring it again making it less likely that it's HSV-1?
3. Are culture tests reliable in the event I get another rash?

[Terri Warren, RN, Adult Nurse Practitioner]

I'm not aware of any sites with more mild looking outbreaks.  The best way to know if some particular skin lesion is herpes it to have it swab tested.

Terri

[GaMan]

All websites I've found of photos of genital herpes are typical cases. Are there any websites that have photos of mild HSV-1 genital cases with description of symptoms?  Assume there's no other way to definititively know unless I have another rash and culture it?  

[Terri Warren, RN, Adult Nurse Practitioner]

I also don't think it is herpes.  Once you have herpes in one location on your body (cold sores) it is highly unlikely, due to your immune response, that you would get it in a new location.  You could get a culture test done of the rash next time, but I'm betting lots of money that it will be negative for HSV 1.  By the way PCP is Primary Care Provider, but personal physician is nice too ;-)

Terri