Round 2

[NecroFlesh]

Symptoms returned, expect worse.
My original post was: http://www.medhelp.org/posts/STDs/Reaction-or-Herpes/show/1916457
So, 20 weeks post exposure my Herpeselect are: HSV 1: 0.41 and HSV 2: 0.06. Now I'm wondering wtf?

12 days after the last encounter with the girl in February I develop symptoms. I had sex with here again toward the begining of  June and about 12 days later, boom same exact thing again. So I have either been given a yeast infection by her twice now, or this is Herpes.

This time, when the itch came on (in the SAME EXACT SPOT as last time), it came out of left field, just BOOM there it is, extreme itching that later became burning. Then there was redness and MAJOR swelling ( the swelling was very pronounced and over a large area) all within a day, so  I decided to put on some Hydrocortisone. Well come day 2 all of the skin in an area much bigger than a quarter comes peeling off and exposes the dermis. This is on the underside of my penis just below the head on the frenulum on the right side, i am circumsized. Unlike last time, this thing is much bigger than a dime and would not stop weeping, it wept for 7 days straight. If I dried it out by sleeping with a fan on my junk, when I got up and put my pants on, it would simply crack and go back to insanely weeping. No constitutional symptoms, so figuring that this could be a fungal infection I put Miconazole 2% cream on there BID, after about 3 days it was starting to resolve. Problem is I don't know if it was resolving on it's own or if the cream was doing it. The sore itself was a giant circle, there was no satellite inflammation, there were never any blisters, but again there were giant deep fissures. It's day 13, still has not fully resolved.

I know hydrocortisone will make a fungal infection explode, but on the flip side I have heard it makes a herpes outbreak worse. Should I get a Western Blot? I've had a total of 4 Heperselect ELISA, all negative.

[NecroFlesh]

Interesting, because it was the fact that this rash recurred in the same exact spot with the sudden onset of itching and burning that progressed into a macerated weeping sore that prompted my concern. I realize that the absence of blisters, inguinal lymphadenopathy and constitutional symptoms help suggest against an infection, ( in addition to the negative labs) but from my understanding atypical herpes presentation (in regards to an actual lesion) can present just as such. There was scaling at the edges of the sore and to be honest the pictures that I saw matched closer to a yeast infection and balanitis, which is uncommon in circumsized men. It's good to hear a voice of knowledge confirm my hopeful suspicions.

[Edward W Hook, MD]

Welcome back to the Forum.  I'm sorry that you continue to worry about HSV.  I read your earlier interaction with Dr. Handsfield and agree with all that he said.  You did not know if your partner had herpes, nothing about your rash sounds like HSV, you have been examined by a dermatologist who felt that your rash was not HSV, and you have multiple negative antibody tests for herpes.  that the rash has recurred in the same location does not trouble me or make me concerned about HSV at all.  There are many dermatological problems which can recur

I see no indication for further HSV testing using either the HerpeSelect or a Western Blot assay.  What I would suggest however is that you arrange to see the same dermatologist who saw you before the next time your rash recurs.  

I hope this comment is helpful to you.  EWH

[NecroFlesh]

It occuring in the same exact spot would be a heck of a coincidence, but then again 20 weeks out I am negative for Herpes. Don't know what the bigger chance is, that I haven't seroconvertered yet or that I got a yeast infection in the same spot twice.