[Question #2478] HSV or Anal Fissure

45 months ago
Hello. I just have a question. I haven't been sexually active vaginally/anally (besides cunnilingus performed on me once) since last August. I did a full STD panel in February and I was positive only for HSV1 (igg blood test) - I've had cold sores sporadically all my life. HSV-2 was negative, always has been. I have this little tiny open sore/cut above my rectal area, on the skin in between. Just one, and it hurts to touch. There's no white center, just a damn cut. I've experienced anal fissures before and had a sigmoidoscopy in April - nothing was found. The anal fissures are usually more linear though, this little open cut is circular. I don't frequent anal sex, think I've tried it once or twice and tested negative for HSV2 after. 

Do you think this is HSV1 genital or HSV2? 
Should I see a proctologist or OBGYN and should they swab me? 

I have OCD so, health concerns are not new for me. Thanks!
45 months ago
Hi. Sorry to be obnoxious. I just looked in the mirror again and it appears the "cut" is coming out of my rectal area. It's more linear then Round and a little big. There's somewhat pain when I pass a stool and for some reason - it's been CRAZY itchy. Like nonstop itching! Is this prodrome? I read fissures are mistaken for herpes often. Would that be possible even with my negative result in February 6 months after any type of sex? (It's been years since I tried anal.)
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
45 months ago
I don't think this is HSV 1 because you've had cold sores in the past, but there may be a very few exceptions. 
Oral sex does not really put you at risk for acquisition of HSV 2, and you've tested negative for HSV 2 by antibody test.
I think you should have this swab tested right away and evaluation by a clinician in person.  is that possible for you?
If you've had anal fissures in the past, it sounds like that's happening again but I would still recommend an in person evaluation

Terri
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45 months ago
I don't think this is HSV 1 because you've had cold sores in the past, but there may be a very few exceptions.  

What are the few exceptions? I had cold sores way before I was sexually active. They're in my family. 

Oral sex does not really put you at risk for acquisition of HSV 2, and you've tested negative for HSV 2 by antibody test.

Should I test again? 

I'm going to the proctologist now to see what she says. I just looked at it again and it seems like I reopened it. It just started pouring blood, so it looks like a cut more so now, less of a fissure. Is it possible to have cuts that aren't herpes related? I have OCD so I'm just freaking out right now.  I don't know what to feel or expect. 
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
45 months ago
I have seen one person in 33 years who reported a history of cold sores and then had HSV 1 swabbed from a genital lesion.  One in 33 years.
I don't think that you need to test again with an antibody test unless you want greater certainty and then you should do the herpes western blot and I also think you should have genital lesions swab tested.  It is most certainly possible to have genital cuts that are not herpes related, absolutely!

Terri
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