Could This be HSV 2?

[oj82]

I'm a male in my early 30's, and recently had protected sex w/ a partner of several months. Roughly one week later, I noticed a red spot (perhaps slightly smaller than a penny) had developed in my pubic hair region. There was no pain, itching, or discomfort associated with it (to the touch included), so I didn't pay it much mind. After a couple of weeks, I trimmed the area, which included the use of a razor. The very next day, I had a larger rash in the pubic hair area which caused little discomfort - other than a bit of itching if I went for a jog or wore jeans that rested on the area. In any event, 4+ weeks have passed, and I still have the rash (perhaps better described as a pinkish discoloration at this point). I've also had 2 separate fissures, or breaks in the skin, which bled but healed quickly (and were not preceded by blisters). I would also add that they were not painful, even to the touch. Does this sound as though it could be genital herpes?

[H. Hunter Handsfield, M.D.]

The additional information doesn't change my evaluation or advice.  No, herpes would not behave the way you describe after shaving.

Nobody can make a specific diagnosis by online description.  From all you say, I see no concern whatever about herpes.  But the only way to know for sure what you do (and don't) have is to see a provider.  This forum can't help further.

[oj82]

Thank you for the quick response DR HHH.

If I may, I would like to ask a quick follow-up. Since I didn't pay the original 'red spot' very much attention, I'd like to focus my line of questions on the period that followed. After trimming the area (with the use of a razor, which came in contact w/ the 'red spot'), would it be possible that herpes could manifest itself more broadly (in the form of a pinkish rash) the very next day? Also (and this is the part of greatest worry for me), would it be possible that the fissures I described could heal within 36 hours (and would be completely pain free)? It's also my understanding that friction from clothing or perspiration alone would be an atypical symptom of herpes - is this accurate? And finally, as far as I can tell, I never experienced non-rash related symptoms, such as headache, fatigue, sensitivity to light, etc -- with what frequency do these types of symptoms manifest themselves during an initial outbreak?

Thank you again for your help Dr HHH.

[H. Hunter Handsfield, M.D.]

I'll try to help.  The bottom line is that almost certainly you need not worry about herpes as a cause of your symptoms.  Genital herpes outbreaks are uncommon in the pubic area, and this location is especially unlikley for the  intial outbreak.  Second, a "red spot" the size you describe does not suggest herpes, and the lack of pain or discomfort also is against herpes.  Finally, herpes outbreaks do not behave as you describe over a 4 week period.  Every herpes outbreak evolves from red bumps to blisters to sores to scabs to healing over 10-20 days.  As far as the fissures are concerned, it's hard to be quite so certain.  But that description also doesn't aound like herpes.

Whatever it is, you can disregard herpes or other STD as the cause. I doubt that it is related in any way to your sexual exposures or anything your partner is carrying.  More likely folliculitis (hair follicle infection) or other superficial skin infection, or perhaps a fungal infection; or some sort of dermatitis. See a health care provider for personal evaluation if the problem continues.

Best wishes--   HHH, MD