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GHSV1? Or Something Else?
Hello,
I was diagnosed with ghsv1 by a swab culture of the lesions by my gynecologist approximately 3 years ago during my initial outbreak. My initial outbreak was extremely uncomfortable and felt like the worst yeast infection in the world, it took almost 2 weeks to feel normal afterwards. Keep in mind this discomfort was all in the vaginal area. It is my understanding that hsv1 has minimal recurrent issues that lessen over time.
With that being said, I am wondering why I have a single sore/ulcer/lesion that keeps reappearing just outside my anus - now 3 years later. It is one single sore (not blister) that appears the exact same way in the exact same location every single time. I have no gland, temperature, tingling, or any other kind of discomfort. It's just an uncomfortable tiny open ulcer that can be uncomfortable for urinating and wiping. I am thinking it could be attributed to something else? Does this sound like ghsv1? It is becoming more regular than ever before, appearing for about a week at a time and happening at least one a month. It sometimes feels like more frequent than that! The center seems to have clear fluid like middle, but has had almost a blood-like fluid inside. I am getting so annoyed and uncomfortable because of the frequency. Please help!
I was diagnosed with ghsv1 by a swab culture of the lesions by my gynecologist approximately 3 years ago during my initial outbreak. My initial outbreak was extremely uncomfortable and felt like the worst yeast infection in the world, it took almost 2 weeks to feel normal afterwards. Keep in mind this discomfort was all in the vaginal area. It is my understanding that hsv1 has minimal recurrent issues that lessen over time.
With that being said, I am wondering why I have a single sore/ulcer/lesion that keeps reappearing just outside my anus - now 3 years later. It is one single sore (not blister) that appears the exact same way in the exact same location every single time. I have no gland, temperature, tingling, or any other kind of discomfort. It's just an uncomfortable tiny open ulcer that can be uncomfortable for urinating and wiping. I am thinking it could be attributed to something else? Does this sound like ghsv1? It is becoming more regular than ever before, appearing for about a week at a time and happening at least one a month. It sometimes feels like more frequent than that! The center seems to have clear fluid like middle, but has had almost a blood-like fluid inside. I am getting so annoyed and uncomfortable because of the frequency. Please help!
MEDICAL PROFESSIONAL
Examination during a flare-up probably is the best bet to make an accurate diagnosis as well as to confirm it isn't herpes.
I am researching this specialist now! Your responses make me feel better. If it is not ghsv1, what are the next steps in determining what it actually is?
I will report back with news once I see this specialist. Again, and always, thank you!
I will report back with news once I see this specialist. Again, and always, thank you!
MEDICAL PROFESSIONAL
Sorry things still aren't clear. Still, I very much doubt this is herpes -- and apparently nothing serious either.
In any case, it appears your gyn is not very knowledgeable about genital herpes, or there was a rather serious miscommunication. Of course a swab test -- ideally a PCR test but at least a culture -- is the standard, most accurate way to diagnose a herpes lesion. In any case, you can expect an HSV blood test to be positive for HSV-1, but no reason to suspect HSV-2. Any other STD blood tests being done (e.g., syphilis, HIV) undoubtedly will be negative.
Next step? I think you should try to see a doctor who better understands herpes. Ask around about an infectious diseases specialist. If you're lucky in your town, there may be a gynecologist who subspecializes in ID. Ask around, look on line, or all your local medical society. In any case, the specific plan should be to see someone who will do a proper test (PCR or culture) the next time you have a flare-up of the sort described above.
In the meantime, stay calm. Herpes is extremely unlikely.
In any case, it appears your gyn is not very knowledgeable about genital herpes, or there was a rather serious miscommunication. Of course a swab test -- ideally a PCR test but at least a culture -- is the standard, most accurate way to diagnose a herpes lesion. In any case, you can expect an HSV blood test to be positive for HSV-1, but no reason to suspect HSV-2. Any other STD blood tests being done (e.g., syphilis, HIV) undoubtedly will be negative.
Next step? I think you should try to see a doctor who better understands herpes. Ask around about an infectious diseases specialist. If you're lucky in your town, there may be a gynecologist who subspecializes in ID. Ask around, look on line, or all your local medical society. In any case, the specific plan should be to see someone who will do a proper test (PCR or culture) the next time you have a flare-up of the sort described above.
In the meantime, stay calm. Herpes is extremely unlikely.
I went to a new gynecologist today because I have no primary care doctor and have recently moved. She says, in her opinion, it is not a cyst. She mentioned that the "tender" inside was concerning and kept asking me if I have had an irregular pap smear or any positive HPV results. The answer is no. She wanted to rule out HSV but did NOT do a swab test as I have had done in the past. She said the swab test provides false positives, or was it false negatives? So she took a blood test to rule out HPV and all others. She suggested two possibilities - hsv with atypical symptoms or as you have mentioned an infection or something similar that gets inflamed. She wanted to rule out all std's with the blood test I am confused why she did not swab it, however. I will say, the PA who examined me just before the doctor said it did not at all look like HSV, was tiny and nothing to worry about. I am more confused than ever before! Your advice really made sense to me. I getting so frustrated because I really just want, whatever this is, to go away!
MEDICAL PROFESSIONAL
Thanks for the thanks; I'm glad to have helped. I'll be interested to hear how it all works out.
Thank you so much! Your answer is right along the lines of what I was thinking. I will get to the doctor this week for an evaluation and follow-up with you asap. I greatly appreciate your thorough and thoughtful response.
MEDICAL PROFESSIONAL
Welcome to the forum. Thanks for your question.
My thoughts about your situation are a classical good news, bad news scenario -- but don't worry too much, the good news is most likely.
The bad first. Could the recurrent ulcer you describe be herpes? Yes.
The good news: I strongly doubt it. As you already know, genital HSV-1 rarely causes such frequent outbreaks. (About 40% have none at all in the next 2-3 years and most of the rest have one or two, then none, at least for a few years.) Frequent OBs can occur but are rare. Second, even the most frequent genital herpes OBs (mostly due to HSV-2) rarely are as often as once a month. Third, although recurrent HSV outbreaks typically occur in roughly the same spot, it's generally within an inch or so. Recurrences in exactly the same spot are not common. Fourth, although single ulcers can occur, most OBs have a cluster of several. Finally, herpes lesions rarely if ever have pus or blood welling up from deeper "inside". (Think of recurrent herpes lesions as being superficial, i.e. "on" the skin, with infected cysts, fistulas, etc welling up from deeper, i.e. "in" the skin.)
I think it's more likely you have some sort of preexisting skin lesion, like a sebaceous cyst or other similar lesion that periodically gets inflamed or perhaps gets a minor infection with staph, strep etc. A somewhat bigger deal might be a peri-anal abscess or fistula, i.e. an abnormal conncection from the inside of your rectum to the skin.
You should be examined by your primary care doctor. I'm pretty certain you don't even need to wait for a flare-up; I'm betting he or she will be able to judge the likely cause without waiting for that. OTOH, you could try to time it with the "outbreak", when the diagnosis probably will be obvious -- but if not, an HSV test can be done on the lesion.
I'll be interested to hear how this turns out. In the meantime, I'm pretty certain this isn't herpes.
Best wishes-- HHH, MD
My thoughts about your situation are a classical good news, bad news scenario -- but don't worry too much, the good news is most likely.
The bad first. Could the recurrent ulcer you describe be herpes? Yes.
The good news: I strongly doubt it. As you already know, genital HSV-1 rarely causes such frequent outbreaks. (About 40% have none at all in the next 2-3 years and most of the rest have one or two, then none, at least for a few years.) Frequent OBs can occur but are rare. Second, even the most frequent genital herpes OBs (mostly due to HSV-2) rarely are as often as once a month. Third, although recurrent HSV outbreaks typically occur in roughly the same spot, it's generally within an inch or so. Recurrences in exactly the same spot are not common. Fourth, although single ulcers can occur, most OBs have a cluster of several. Finally, herpes lesions rarely if ever have pus or blood welling up from deeper "inside". (Think of recurrent herpes lesions as being superficial, i.e. "on" the skin, with infected cysts, fistulas, etc welling up from deeper, i.e. "in" the skin.)
I think it's more likely you have some sort of preexisting skin lesion, like a sebaceous cyst or other similar lesion that periodically gets inflamed or perhaps gets a minor infection with staph, strep etc. A somewhat bigger deal might be a peri-anal abscess or fistula, i.e. an abnormal conncection from the inside of your rectum to the skin.
You should be examined by your primary care doctor. I'm pretty certain you don't even need to wait for a flare-up; I'm betting he or she will be able to judge the likely cause without waiting for that. OTOH, you could try to time it with the "outbreak", when the diagnosis probably will be obvious -- but if not, an HSV test can be done on the lesion.
I'll be interested to hear how this turns out. In the meantime, I'm pretty certain this isn't herpes.
Best wishes-- HHH, MD
You are reading content posted in the STDs Forum
Herpes spreads by oral, vaginal and anal sex.
Herpes sores blister, then burst, scab and heal.
STIs are the most common cause of genital sores.
Millions of people are diagnosed with STDs in the U.S. each year.
STDs can't be transmitted by casual contact, like hugging or touching.
Syphilis is an STD that is transmitted by oral, genital and anal sex.
