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Avatar universal

hard bumps = herpes? / folliculitis

I'm sorry for asking so many questions but have seen 3 doctors without any resolution...and have just exhausted one 10 day dose of Valtrex and Cephalexin. This is now in week 4 and I can barely walk without pain.

I am HSV-1+ (IGG), but two cultures (PCR) are negative. I have never had any kind of outbreak before (anywhere) and am SURE this is not a recent exposure. My wife is HSV-1/2 negative, we just got that result.

Right now I am in excruciating pain. My scrotum has large pus-filled bumps (that's how this started 3+ weeks ago), which started off on the left side, and on the left and right ends, where the scrotum skin attaches to normal skin, it's very "rough" and bleeding. My thighs have symmetrical red lesions (which coalesced into a giant mark) which somewhat crusted over but are certainly not healing, and my last doctor (dermatologist) claimed they looked 100% like herpes, but there's no fluid, and it feels like a large, red, subcutaneous lump on each side. He's stepped away a bit from that diagnosis after the PCR was negative for HSV but still thinks it's viral.

The redness has extended around those giant bumps, almost like I got hit there with a tennis ball. There's no pain for the "ring" -- it just looks like an inflammatory response. I can't imagine a trained dermatologist (not to mention 3!) would mistake herpes for jock itch...but this certainly does have a "ring" now after 3 weeks.

Additionally the hair follicles seem to be infected with something (one of the sores between penis and scrotum continues to "leak" and the hair around it hurts), but it's certainly not getting better from the Cephalexin, which I've been on for 2+ weeks (was positive for a rare staph strain, in culture, but it seems unlikely that's the cause)

Is there some kind of specialist I can see? 3 dermatologists now...and I can barely function as a human. One other thing: one of the raised "marks" on my penis almost disappeared when I applied betadine to the whole area.
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Avatar universal
But herpes isn't logical here. It looks like you've had HSV1 since your youth, most people do. With these antibodies, then another infection with HSV 1/2 would not be likely to present as a severe outbreak.

HSV1 is virtually impossible to acquire genitally once you have an established oral infection. If your wife doesn't have HSV2 and you've not been playing away games, then it can't be that.

You've had negative swabs of the best, most sensitive test for surface HSV there is.

The most practical explanation if it is herpes is that you acquired a genital HSV1 infection prior to your wife and you are having a material immuno issue just now. Even this seems unlikely as the scrotum is not a great place for herpes lesions as the skin is really thick and there are comparatively fewer nerve endings compared to the penis.
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Avatar universal
I think herpes is quite likely, actually, but there must be something else going on here too. And how would this last 4 weeks with no recent exposure?

I wish I could see some day-by-day pictures of various skin conditions to get a better sense here. The main "weird" thing about what I have is the raised bumps on the thighs that seem to not be bacterial, but I can't really find any standard pictures of herpes progression online. Just clusters of well defined, individual fluid filled dots on a raised base. I have the raised base and a ring of redness around it, but that's basically it.
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Avatar universal
It would seem then that you have eliminated herpes as a cause to 100%.

Quite poor that a dermatologist cannot help you, they are normally very good and often have good knowledge extending into immunology and infectious disease.

From what you describe maybe seek out an infectious disease specialist as a next step.
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