Possible Herpes/STD?

[gtx10]

Dear Doctor, thanks in advance for answering my question. I have had a series on encounters with CSWs over the past year, engaging in protected vagina and protected oral sex. It is possible that some salive contacted my groin/crotch area during the process.

About 2 months ago, 2 weeks after an encounter, i developed an itchy rash directly above my pubic area, It was an irritation which caused me to scratch frequently, but i did not notice any pus/lesions, other then where severe scratching broke the screen(but i cannot be too sure of this). The rash has since spread sideways to my hip bone. Much of it has recovered, ceased to itch and turned into a light brown patch of dead/dry skin by now. The rash did not extend to my genitals and below the pubic region.  The only other region where i had an itchy rash was around the area crossing my hamstring and right buttock.

Can i enquire if this rash is a possible indication of herpes or any other STD? I did not experience any other symptoms elsewhere and on my genitals, but this rash is quite persistent, although it is fading. Worried sick out of my mind. Thank you so much for your assistance.

[Edward W Hook, MD]

Testing at this time will provide definitive evidence of the presence or absence of most STDs. Definitive evidence for HIV could take longer- HIV antibodies tests are definitive at 8 weeks following exposure.  My own sense from what  you describe however is that worry about STDs is not likely to tell you what is causing the rash and may delay you from finding out what is really causing it.   EWH

[gtx10]

Thank you for your reply Dr Hook. I intend to put an end to my activities and undergo comprehensive STD tests. My previous encounter was 1 month ago - would it be appropriate to undergo these tests now, including a hiv one? thanks again

[Edward W Hook, MD]

Welcome back to our Forum.  In evaluating clinical findings and, in particular rashes, there is no substitute for examination by an experienced clinician.  I would urge you to make and appointment to be seen by a clinician who is familiar with rashes and genital skin lesions for evaluation.  In the meantime however I will make some comments which I hope will be helpful but are not meant to take the place of the examination I have just recommended.

The rash you describe is not suggestive of herpes infection of for that matter, other STD.  The rash of herpes, even initial rashes do not last more than three weeks and as I read your description, it appears that your rash has been present longer, perhaps 5 or 6 weeks.   Secondly, for your information, herpes is not transmitted by saliva contact on skin so this too makes herpes unlikely.  Finally your description of the rash and its course is not suggestive of herpes or other STD either,. From at distance and without examining you, it occurs to me that the rash you describe could well be a fungal infection, unrelated to your sexual activities.

I hope this comment is helpful to you.  Please let us know what your doctor thinks.  EWH