[Question #185] herpes

37 months ago
Dear Terri. Thanks for your help yesterday.  Sorry for te over posting just wanted to make sure I was clear. I have a few follow up questions. In your first post you said not to worry unless the rash returns. What changed that made you recommend a test? Also in the first post you said that this activity (genital rubbing, and genital to anus rubbing) where not a risk of hsv-2. Correct?  Let me say that I have NEVER engaged in unprotected intercourse,  anal or vaginal,  even for a second, except with a long time girl friend many years ago.  I have never had any lesion or blisters on my penis or in this area. Since you indicated that my main risk is of hsv-1, could this show up in this manner as a reaccuring symptom of hsv-1? Also you indicated that in your thirty plus years of cases you have only seen this placement of the rash a handful of times. In those cases had the patient had symptoms prior in the genital area? And where any of these cases do to hsv-1? What are my risks of hsv-2 with use of a condom?   
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
37 months ago
When people seem to accept that something is unlikely to be herpes pretty easily and the risk seems low, I may or may not recommend testing.  But in this case, you seemed to still be a bit worried and testing often helps to put someone's mind at rest. 
Condoms reduce transmission, depending upon the study you read, 30-50%, sometimes more.  The problem with condoms is that parts of your body vulnerable to herpes aren't always covered by a condom or condoms slip or break.  They are certainly better than no condom but they aren't perfect. 
If you had either HSV 1 or HSV 2, it is possible that it would manifest in this way, just really unlikely. 
In the previous cases where I have seen rashes on the back of the knee or on the ankle or the foot, sometimes there have been genital lesions and sometimes not.  I'm just dealing with a woman who has only outbreaks on her ankle that were finally diagnosed by PCR as HSV 2.  She had had no outbreaks genitally.  I honestly don't know if any of these cases where HSV 1
I honestly think the chances are quite slight that this was due to herpes but I can't say no for certain.

Terri
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37 months ago
Thanks Terri,
I will risky this is be tested. I'm not that worried though.  Since I paid for more questions I will ask a follow up. You say that this was almost definitely not related to the encounter the day before. Correct?  The only other sexual encounter I have had this year was in February.  Once again unprotected oral. (Never again, didn't realize how risky this is). Before that was more then a year and a half earlier. What are the possibilities of me being asymptomatic all that time and then having an outbreak of this magnitude? 
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
37 months ago
I'm not sure what you mean by that first sentence, perhaps you can clarify.  If you're like me sometimes your brain moves faster than your keyboard!
No, even if you had brand new herpes, it wouldn't show up that fast.  So Correct. 
I wouldn't describe receiving oral sex as risky but I would say it is not risk free.  Most of the HSV 1 genital infections that I see in our clinic are mouth to genital transmission.  It is unusual to acquire other STI's from oral sex. 
If the knee thing IS herpes, which I doubt, it could be present from an infection years ago, no way to know

Terri
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37 months ago
Thanks,
  Crazy thing. Last night I notices a pink welt on the back of my upper thigh. This morning it is much bigger about six or seven inches across.  There are no blisters or ulcers of any kind.  It is actually completely smooth but a little tender if I push on it. It is also in a location where my jeans seem to rub on my leg. Does this sound like it could be another outbreak 5 weeks later?  Every picture I see shows some sort of blister or ulcer.  Also I figured it could be another allergy and took benadryl which reduced the swelling. When the benadryl wore off five hours later the swelling increased again. Would benadryl have this effect on a herpes outbreak?  Also would you normally expect the outbreak to be near the last one. This is not even close to it.  My first sentence on the other post was meant to say I will get tested. Thanks for your help.
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
37 months ago
If Benadryl make it better, then it is likely not herpes.  Benadryl has no impact at all on herpes.  Usually yes herpes has blisters or ulcers.  Six or seven inches across?  Wow, you need someone to look at that, that's pretty big
Terri
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37 months ago
BTW the welt is gone
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
37 months ago
I'm so glad.  Now that REALLY sounded nothing like herpes to me, Gregory

Terri
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