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Herpes concern, with negative tests
Doctor,
Thanks in advance for reading this. My situation is this: I'm a male, age 29, and 3 years ago (January 2006) I went through what I thought was a Herpes scare. I found a very small paper cut-like tear on my penis, just below the shaft. It was over a long weekend and by the time I got to the dermatologist (three days later) it had scabbed over and flaked off. He could barely see anything and wasn't worried and told me my description wasn't at all what herpes sounds like.
But I still panicked and had myself tested (HerpeSelect test) 4 times over the next 6 months. All tests were negative for both types I and II. I also saw another dermatologist (with no symptoms -- just to run everything by him) who was also adamant that I didn't have it and suggested eczema. So I finally put it out of my mind.
Then, in February 2008 I found a similar, tiny paper-cut like tear on my penis. Location was different -- mid-shaft this time. I was living in a different city, and I went to a doctor that day. He looked at it, said it didn't seem like herpes, but that it could be possible and that we should take a blood test -- HerpeSelect again. Results were again negative for both types. Again, I put it out of my mind. (BTW, the tear wasn't big enough to do a culture.)
Now, just two days ago, I noticed another one, time under my shaft. At first I thought it was a tiny piece of lint or something, so I scraped at it and realized it was a tiny cut/tear and had scabbed over. (By tiny, I mean less than a millimeter). And now I'm panicking about herpes again.
So I've had the same basic paper cut/tear 3 times over 3 years, with 5 negative HerpeSelect tests, and 2 dermatologists have told me not to worry about herpes. But I just wonder what else it could be? I definitely have some kind of eczema; my fingers get dry and get tears and I itch all over the place a lot -- including my scrotum. Could it be connected? I'm going out of my mind with worry.
Thanks in advance for reading this. My situation is this: I'm a male, age 29, and 3 years ago (January 2006) I went through what I thought was a Herpes scare. I found a very small paper cut-like tear on my penis, just below the shaft. It was over a long weekend and by the time I got to the dermatologist (three days later) it had scabbed over and flaked off. He could barely see anything and wasn't worried and told me my description wasn't at all what herpes sounds like.
But I still panicked and had myself tested (HerpeSelect test) 4 times over the next 6 months. All tests were negative for both types I and II. I also saw another dermatologist (with no symptoms -- just to run everything by him) who was also adamant that I didn't have it and suggested eczema. So I finally put it out of my mind.
Then, in February 2008 I found a similar, tiny paper-cut like tear on my penis. Location was different -- mid-shaft this time. I was living in a different city, and I went to a doctor that day. He looked at it, said it didn't seem like herpes, but that it could be possible and that we should take a blood test -- HerpeSelect again. Results were again negative for both types. Again, I put it out of my mind. (BTW, the tear wasn't big enough to do a culture.)
Now, just two days ago, I noticed another one, time under my shaft. At first I thought it was a tiny piece of lint or something, so I scraped at it and realized it was a tiny cut/tear and had scabbed over. (By tiny, I mean less than a millimeter). And now I'm panicking about herpes again.
So I've had the same basic paper cut/tear 3 times over 3 years, with 5 negative HerpeSelect tests, and 2 dermatologists have told me not to worry about herpes. But I just wonder what else it could be? I definitely have some kind of eczema; my fingers get dry and get tears and I itch all over the place a lot -- including my scrotum. Could it be connected? I'm going out of my mind with worry.
MEDICAL PROFESSIONAL
Welcome to the STD forum. The bottom line is that I'm quite sure you do not have genital herpes. And for what it's worth, I have seen teh follow-up comment about head vs shaft.
I was pretty sure you didn't have genital herpes based only on the title you used for your question. Why? Because herpes diagnosis by symptoms and professional examination is inherently much less reliable than laboratory testing. When a reliable blood test like HerpeSelect gives an answer that conflicts with symptoms or physical examination, generally the blood test is correct.
It is true that herpes is the most common cause of ulcerative lesions of the genitals, especially recurrent ones. However, it isn't the only cause. And the lesions you describe really don't sound much like herpes. Most important, herpes rarely heals as rapidly as you describe. Once HSV reactivates and causes a skin lesion of any kind, it generally gets worse for at least 4-5 days, before it starts to improve; and total time from onset to complete healing is always at least a week, usually 10-14 days.
Secondarily, dermatologists are very good at recognizing HSV lesions. The opinion of two of them that you don't have herpes is very strong evidence.
So combining the symptoms you describe, the dermatologists' opinion, and the blood test results, it is virtually impossible that you have genital herpes. As to what actually is the cause of your penile lesion, I really can't say. The best way to sort that out would be to see a provider -- once again, a dermatologist would be ideal -- within a day of onset of another such lesion. But in the meantime, I really don't think you have anything to worry about with respect to herpes.
I hope this helps. Best wishes-- HHH, MD
I was pretty sure you didn't have genital herpes based only on the title you used for your question. Why? Because herpes diagnosis by symptoms and professional examination is inherently much less reliable than laboratory testing. When a reliable blood test like HerpeSelect gives an answer that conflicts with symptoms or physical examination, generally the blood test is correct.
It is true that herpes is the most common cause of ulcerative lesions of the genitals, especially recurrent ones. However, it isn't the only cause. And the lesions you describe really don't sound much like herpes. Most important, herpes rarely heals as rapidly as you describe. Once HSV reactivates and causes a skin lesion of any kind, it generally gets worse for at least 4-5 days, before it starts to improve; and total time from onset to complete healing is always at least a week, usually 10-14 days.
Secondarily, dermatologists are very good at recognizing HSV lesions. The opinion of two of them that you don't have herpes is very strong evidence.
So combining the symptoms you describe, the dermatologists' opinion, and the blood test results, it is virtually impossible that you have genital herpes. As to what actually is the cause of your penile lesion, I really can't say. The best way to sort that out would be to see a provider -- once again, a dermatologist would be ideal -- within a day of onset of another such lesion. But in the meantime, I really don't think you have anything to worry about with respect to herpes.
I hope this helps. Best wishes-- HHH, MD
A related discussion, herpes lesion heal time was started.
Doctor,
I'm sorry to belabor this. I promise, I'll leave it at this. But I went to a dermatologist today, who looked at (what's left of) the ulcer on my penis. It was the usual story -- he wasn't that worried, said it didn't look like herpes but couldn't say for sure it wasn't, couldn't culture it, and said we could take the blood test one more time -- just for peace of mind, I guess. So they drew blood for HerpeSelect and I'll get the results next week.
I left feeling good, but my mood changed tonight, when I started thinking about this. The fact that I've had three actual ulcers about 1 mm. wide on my penis three different times really seems weird. If it's friction or something causing it, how come I never get any other kinds of scrapes or marks on my penis -- just these 3 identical ulcers, 3 different times?
With that in mind, and based on the info I found here and elsewhere, I'm just wondering if the following chain of events seems reasonable (or not) to you:
* I'm satisfied that I don't have HSV-2. The symptoms are too mild and infrequent and the tests are always negative. OK, I don't have that.
* I do have genital HSV-1. This explains why the symptoms are so mild and inftrequent -- gHSV1 outbreaks are rare, mild and brief, right? Plus, this explains the negative test results. From what I can tell, there are a decent number of false negatives for HSV-1 (more than for HSV-2). Is this accurate? If so, wouldn't it sort of make sense that I have gHSV-1, that I'm one of the 10% or whatever who don't ever test positive, and that my mild symptoms are the result of having gHSV-1 instead of gHSV-2? (It might make sense as welll because I received oral sex several times from different partners before I ever got any symptoms. So wouldn't it be logical that I got it this way, that I didn't have a primary outbreak, and that the 3 episodes I've had have been recurrences -- i.e. milder than primary.)
I can't get this scenario out of my mind. It just seems to add up. I'm sorry to burden you with this. I'd really be interested in your feedback, though. And, really, I do promise I'll leave it at that. Thanks much.
I'm sorry to belabor this. I promise, I'll leave it at this. But I went to a dermatologist today, who looked at (what's left of) the ulcer on my penis. It was the usual story -- he wasn't that worried, said it didn't look like herpes but couldn't say for sure it wasn't, couldn't culture it, and said we could take the blood test one more time -- just for peace of mind, I guess. So they drew blood for HerpeSelect and I'll get the results next week.
I left feeling good, but my mood changed tonight, when I started thinking about this. The fact that I've had three actual ulcers about 1 mm. wide on my penis three different times really seems weird. If it's friction or something causing it, how come I never get any other kinds of scrapes or marks on my penis -- just these 3 identical ulcers, 3 different times?
With that in mind, and based on the info I found here and elsewhere, I'm just wondering if the following chain of events seems reasonable (or not) to you:
* I'm satisfied that I don't have HSV-2. The symptoms are too mild and infrequent and the tests are always negative. OK, I don't have that.
* I do have genital HSV-1. This explains why the symptoms are so mild and inftrequent -- gHSV1 outbreaks are rare, mild and brief, right? Plus, this explains the negative test results. From what I can tell, there are a decent number of false negatives for HSV-1 (more than for HSV-2). Is this accurate? If so, wouldn't it sort of make sense that I have gHSV-1, that I'm one of the 10% or whatever who don't ever test positive, and that my mild symptoms are the result of having gHSV-1 instead of gHSV-2? (It might make sense as welll because I received oral sex several times from different partners before I ever got any symptoms. So wouldn't it be logical that I got it this way, that I didn't have a primary outbreak, and that the 3 episodes I've had have been recurrences -- i.e. milder than primary.)
I can't get this scenario out of my mind. It just seems to add up. I'm sorry to burden you with this. I'd really be interested in your feedback, though. And, really, I do promise I'll leave it at that. Thanks much.
Thanks so much for the speedy reply. That's great to hear -- I was really expecting that you'd be more worried; your confidence is very reassuring, and I've been driving myself insane today surfing the 'net for possible explanations. (I actually live on the East Coast, where it's now almost 3 AM, but I've been waiting up, hoping there might be a reply from you -- now I can get some sleep.) Many thanks again....
MEDICAL PROFESSIONAL
I saw it. See above.
I hope you see this before you reply -- I made a mistake in my question. I wrote about two of the tears being "just below the SHAFT." I meant "just below the HEAD." I have no idea why I confused these two. Sorry for the confusion
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.
