Atypical Herpes

[colourfulrainbow]

I have received a positive blood test from 7.5 months post exposure (negative at 6 months) for hsv1.  I believe I contracted both oral and genital at the same time.  I can't get a positive swab for either.

I get nerve pain, pins and needles, numbness, itchiness on and off for 9+ months, burning etc. entire face (mostly concentrated on neck and left ear), vulvar area, anus, legs.....no typical lesions.....

The lesions I have appear as pimples, tiny, pink, not really red that itch before they come and then disappear wtihin days or weeks, never get fluid, never in clusters, don't scab unless I itch them.  If I itch them they bleed.  They appear on my tailbone area, upper bum, thighs.  They are inches apart sometimes there are lots sometimes few.  No one will swab them b/c they don't look herpetic and no fluid.  

I have been to a dermatologist but can't get there within 48 hours to do a biopsy.  Has anyone experienced herpes like this?  Also, if the pimples are in tact, do they have to be biopsied wtihin 48 hours or can I have them do it later?

Thanks,

[colourfulrainbow]

Thanks again Howard!!!!

[HowardH]

I don't know the answers to most of these questions. I think eczema herpeticum is both -- standard (allergic) eczema that has been infected with HSV1. But I'm not an expert and really don't know for sure. However, this should be bread and butter for most dermatologists. All I can suggest (again) is that you see a dermatologist and take it from there.

[colourfulrainbow]

Sorry, last question....

why if herpes simplex 1 does not travel through blood, does it get to all these different places even though skin is weak here?  Is it because of autoinocculation or are you more suseptible to disseminated herpes if eczema is an existing condition or is it the nature of the beast?  Why would it travel?  I don't get it.  Sorry, if this is too detailed, but I need to understand it medically and I haven't found a good site yet that explains it.

Thanks again!

[colourfulrainbow]

Wow! OK...those images are going to haunt me forever.

I think they mentioned the pustules have to be umbilicated or depressed which mine don't appear to be....but I have seen a derm and she said it may be eczema, I told her I had a positive hsv1 blood test recently and she didn't mention eczema herpeticum at all.

How do you swab something like a pustule with no fluid?  Is it still accurate?  Seems like not a lot of virus would be present on something like that vs. a fluid filled one.

I have suspected I have disseminated herpes for a while, but b/c it's so rare, no one believes I could have it.  But I have similar symptoms everywhere and MRI is negative.  

Anyway, Howard, your advice on how to best swab a non-vesicular pustule and how accurate would it be....thank you

[colourfulrainbow]

I wanted to ask about non fluid biopsy vs. swab.

I do have eczema....it comes and goes...mostly I get it on my hands, sometimes around my mouth, and on my upper back.

Is eczema herpeticum herpes or is it eczema or both?  I guess these would be contagious then.

[HowardH]

Welcome back -- but understand you're not likely to get different opinions or advice by asking the same questions in new threads.

I'll just say (again) that your symptoms and description of the rashes are not typical for herpes (but you already know that). However, there is a condition called eczema herpeticum, in which standard allergic eczema is complicated by a secondary infection with HSV1. Look at online photos of it.

You may not need to see a dermatologist within 48 hours of onset to get an accurate diagnosis.  Get an appointment any time your rashes are active, then follow the advice you get if he or she wants to see you again early in the course of a new outbreak for a swab test to look for HSV by PCR or culture. (Not a biopsy, which isn't usually used to diagnose herpes.)

[colourfulrainbow]

Oh, all doctors look and say not herpetic, but I feel I get typical prodome before.  It's exhausting trying to figure it out.  I know it's not hsv2