[Question #1494] Please give me your advice on possible STD
98 months ago
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Hi Doc,
I am an older guy who
got hooked up with a swinging couple. The woman performed oral on me for about 20
seconds. About two weeks later I develop two red spots on the front upper shaft of my
penis. I keep it trim there and the hair was stating to grow back on the upper
shaft where the red spots or [bumps] were. I could see NO fluid associated with them and they
were spaced about ¾ of inch apart. They were entirely painless and the slightly
bigger one had shiny look to it. I could however feel a little thickness under the
bigger one but no broken skin or pimple head just smooth and flat. The smaller
one took 2.5 days for the redness to go and the bigger one 4 days but being
fair skinned I could still see evidence of where they were and could feel a
little bump [or thickness] under the skin of the bigger one for a couple more
days then they were gone.
About a week after that, my penis got tender on the back
side of the head including the tip. It simply felt like sensitive nerves but NO
discomfort while urinating. During the next week, the sensitivity on the head
subsided the tip seems just a little sensitive when I think about it.
Tested at the STD clinic and I am NEG for, HIV, Syphilis, Gonorrhea and Chlamydia. They did not find any swollen glands during exam. They said to wait another month before I take the herpes test. I also went to a urologist and he could find nothing. He said he didn’t know why my penis was sensitive but said the lesions I described did not sound like herpes. Everything is gone now but I am worried about passing whatever this is on to my grand kids especially herpes they are very young
Thanks
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Edward W. Hook M.D.
98 months ago
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Welcome to the Forum. I'll be pleased to comment. The lesions you describe sound more like folliculitis than herpes or any other STI. Folliculitis occurs when the microscopic pits in the skin that hairs grow out of become plugged and normal skin bacterial cause a reaction which may appear in any way ranging from red bumps to small pimples. There does not need to be a visible hair present for this to occur. Folliculitis is more common after shaving which predisposes hair follicles to become plugged and tends to go away with soap, water and gentle washing. In contrast, herpes lesions most typically form small, fluid filled blisters which spontaneously open up. Often but not always they are uncomfortable. In your case, the fact that these lesions appeared following receipt of oral sex also tends to weigh against the diagnosis of herpes as more than 60% of adults have already been infected with HSV-1, the virus that causes cold sores (whether they know it or not- most people with HSV-1 do not know it).
I will also urge you not to pursue this with a herpes blood test. As it happens, this very week, The Journal of The American Medical Association (JAMA) will publish official recommendations from the U.S. Preventative Services Task Force and an accompanying editorial that I wrote both recommending against blood tests for herpes in most people because of problems with test performance (questionable sensitivity, high rates of falsely positive results). In situations such as yours, unless the lesions occur at which time further evaluation is warranted, I recommend against the HSV blood test. Even if it were positive, you would not know if the result reflected recently acquired herpes or prior herpes that you did not know you had (most Americans with either HSV-1 or HSV-2 do not know they are infected).
For all of the reasons above, I would advise you not to worry about this unless the lesions recur. If that happens, it would be farbetter to seek a HSV-PCR test than to pursue the diagnosis with a blood test. I hope these comments are helpful to you. EWH
98 months ago
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Edward W. Hook M.D.
97 months ago
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1 No, I do not think your penile tenderness is related.
2. There is no reason to think it was genital herpes of any sort. If it was, the only risk would be to future sexual partners.
3. No the firmness you describe does not suggest herpes and does not suggest the presence of fluid.
EWH
97 months ago
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Edward W. Hook M.D.
97 months ago
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97 months ago
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Edward W. Hook M.D.
97 months ago
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Your summary agrees with my reading of your posts. One last time, I urge you not to worry further.
Forum guideline call for up to three replies per question. This thread will be closed later today. Take care. EWH