Advice needed badly...

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H. Hunter Handsfield, M.D,

About 8 months ago I had a spot appear on the base of my penis.  As you can read my previous post, I was very worried about the situation.  The spot took a little more than a month to clear.  I took a herpes 2 blood test along with various other blood test about 6 months later.  All blood test came back negative.  One week ago I had a similar spot appear in roughly the same place.  Except this time there was multiple blisters which formed almost in a line at the base of my penis in the hair follicle area.  The blisters have popped, almost coming together forming one sore.  One week later on Monday, 5 to 6 more blisters have appeared just above the other spot in the hair area along the side of my shaft.  They formed in a similar line mirroring each other, they lay on each others.  Literally in the fold between base my penis and testicular sack.  Like one may have caused the other and spread over a weeks time. Sounds weird, this is the side my penis naturally lays on.  This also tends to be an area I probably scratch because of the constant skin on skin contact.  Today, smaller bumps/blister have raised up outside of my line area and on the shaft.  Does herpes typically form and then begin forming again a week later, and then more being created a few days later?  Its like i have had three differnt outbreak within a week and half.  The outbreak seem to be spreading now from original areas in my hair at the base of my shaft and today another outbreak formed on my shaft (smaller in size but will probaly grow).  Two weeks ago i had an infection in my jaw and fever set in.  Again all my blood tests have come back negative and I've monogamous for almost 10 months now.  Today I was told by dermatologist to get blood testing done for syphillis and herpes 2 and i did.  so i will have another blood test result in 2 days.  I am also very active in contact sports.  Looking for some medical answers.  Please help...

[Edward W Hook, MD]

Thanks.  You need to be seen.  Trying to make a diagnosis over the phone is not in your best interest.  EWH

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Thank you for your quick response.  I haven't formally seen the dermatologist, but instead had contact over the phone.  Once the blisters bust they don't crater into the skin, if that matters.  These blisters are not easy to pop and aren't super fragile.  I am in the process of getting into a dermatologist and awaiting my most recent blood test results.  I am very much involved in contact athletics and sweating is impossible to stop.  Not to mention i'm constantly in the heat.  

[Edward W Hook, MD]

Dr. Handsfield and I share the forum.  You got me.  FYI, the reason we share the forum is because we have worked together for nearly 30 years and while our verbiage styles vary, we have never disagreed on management strategies or advice to clients.

Welcome to the Forum.  In preparing to address your question I reviewed some of your recent interactions with my friend Terri on the HSV Expert site as well.  It appears that the evidence that you have HSV is rather low but it remains a possibility.  I agree with her suggestion that you get a swab test for HSV culture or PCR. This should be available through your dermatologist or his laboratory.  I also agree with her suggestions regarding the benefit of your partner also getting tested in clarifying this. As Terrie pointed out, health care providers do not regularly test for HSV when "routine testing" is done and it would be good for her to ask her health care provider directly about this. The information will be helpful to both of you.

If this is not HSV and that is my suspicion, what could this be?  Well from your description this could be a bacterial skin infection due to staph or strep?  It may have started as something else and then become infected as staph and strep both are normally found on the skin but can causing spreading infections when there is an open sore or other place for the infection to get into and spread.  Alternately, among infections it could be a fungal infection as well- the location is typical and while the spreading and blistering that you describe would be unusual for fungal infections, it does happen. Another possibility is that this may not be an infection at all but some other kind of dermatological problem.  

My advice would be that you return to the same dermatologist you saw before, and ask about the possibilities I have mentioned.  Sometimes to sort out these sorts of problems there is a bit of trial and error involved and that you have already been seen by him may be helpful.

Hope these suggestions are helpful.  If the rash is spreading you should be seen sooner than later.  EWH