[Question #2106] STD question

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89 months ago
About two days ago, i developed a few bumps on the head of my penis. It is the second time this has happened, the first time (around February) I went and got a full std check, including one for herpes and everything came back negative. Everything has been fine, have exhibited absolutely no symptoms.Except for these three bumps. They quickly scabbed over, never were open wounds, they do not itch or have any pain associated with them. Just these blister like bumps that within 15 hours were scabs Since December I have been with the same person monogamously. We both got Std checks when we first got together and everything was clear. And a second time that I mentioned previously, also all clear. Is it safe to rule out herpes? I asked a friend of a friend who is a doctor, he looked at a few pictures i sent and he said they were fordyce cysts. He seemed very confident in his answer. I really dont feel like herpes is what i have but I am curious as to why I would get random bump and then scabs on the head of my penis so abruptly.
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Terri Warren, RN, Nurse Practitioner
89 months ago
When you say that you tested for everything and herpes came out negative, can you tell me more specifically what testing was done?  Swab test, blood test, IgG, IgM?  Did your friend see a picture of the bumps when they were at their peak?  I've not heard of Fordyce cysts, only Fordyce spots, which are a form of sebaceous gland and are completely normal.  They can show up on the lip, labia or shaft of penis.  I think a dermatologist evaluation when the bumps are there would be the best strategy to find out exactly what they are.

Terri
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89 months ago
There was nothing to Swab when I went in. Turned to scan almost immediately. Got tested for igg and igm. Both types and everyrhing came back negative. At that time (around February) I had already been in a monogamous relationship for a little more than two months. I am still in that relationship and have had no other sexual partners. Getting in to see a derm is a little tough right now. But in this instance these bumps were scabs almost immediately. I'm just not sure what would cause scabs on the head of my penis. From what I understand about herpes tho, the only symptoms that match are the location. Not pain or itching not the stages Of ulcers and sores. I'm more just wondering what could cause bumps and then quick scabs. Sorry if this is vague. Appreciate the help. 
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Terri Warren, RN, Nurse Practitioner
89 months ago
I suppose a kind of dermatitis or psoriasis might produce something you might call a scab but it comes and goes so quickly, that seems unlikely as well.  I don't think that herpes lesions wold turn into a scab so quickly and I also don't think that Fordyce spots actually scab over.  If there is no sore or ulcer, I'm not sure how there is a scab - what is scabbing over then?  You and I might be using a different definition for scabs, also.  In order for a scab to form there is something underneath that is healing.  I'm puzzled by this and sorry I cannot be of more help.  I wonder if you are describing more dry skin than scabs?

Terri
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89 months ago
They were these very brief bump like blister that never really opened up or anything. A little bit of clear fluid when they popped or whatever adjective you'd like to use. I say popped for lack of a better word. But instead of being open cuts after this. They hardened and now look very much like scabs. It's just hard to get into a doctor. But it's very odd. I visited my girlfriend this past weekend and thought maybe it could have been from friction I'm just more lost than anything. But to describe it as best as possible. These cleanish bumps appeared and then within 15 hours, they were scabbed over. Never opened up never has visible sores. Just went from a bump to a scab. No pain or itching or anything. Could it possible be a fungus or bacteria? 
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Terri Warren, RN, Nurse Practitioner
89 months ago
I suppose it could certainly be fungal - bacteria less likely I think. 
The HSV 1 IgG test misses 30% of infections compared to the gold standard western blot so you might want to consider getting the blot to be certain you don't have HSV 1.  You could also try an over the counter antifungal medication but it doesn't sound like they hang around - they come and go which is the only herpes concerning aspect of this presentation.  I asked another physician friend of mine if they had any ideas and they did not. 

I do hope that you will consider a derm appointment and if possible, take a picture of these scabs and take them with you in case yo don't have any bumps or scabs at the time you are seen. 

Friction could also be a cause but it doesn't sound like they are always associated with sexual friction, right?

Terri
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