[Question #2527] Reconciling Test Results and Unexplained Symptoms

44 months ago
Good Afternoon and thanks for a great service.

I (M) have been in a monogamous relationship for 10 years, though had other partners (both protected and unprotected) prior to this relationship. It seems as though I have been afflicted with the same anxiety of many other posters due to some of those decisions and recently came to find that the testing is not 100%. I have never had a sore/lesion on my penis, though I do get red bumps that might resemble pimples or folliculitis in my groin/thigh area. I understand these to be what they are - folliculitis. About a week ago, I found 2-3 small (pen hole size/pencil tip size) red bumps next to each other just on the outside of my pubic hair (I do not shave). An inch or so away there were two more. Admittedly, last weekend I did yard work and did not shower on Saturday or Sunday until the evening and it was hot. The hesitancy of accepting these as something like folliculitis is that they are in a place where I do not have hair. For lack of a better description, it is where the groin goes into a "V" towards my hips/abdomen. I have no pain or itching involved. The bumps have not changed in nature, other than they've gotten less red and are clearly going away (I first noticed them last Monday). I have been applying over the counter hydrocortisone which I attribute, perhaps incorrectly,  the healing to. Lastly, I have had multiple igg tests negative (my long-time partner only has HSV1) and even a Western Blot that was negative. I have never been tested to my knowledge for HPV or MC. 

1.) I've had shingles after a bout with cancer and chemotherapy, so I understand the life cycle of a similar virus. Does this sound anything like HSV or any other STD? I understand the testing misses some people and the penis is not always involved.

2.) Does the assumed reaction to hydrocortisone and/or the timing lead you to any assumptions about what these are?

3.) I'm assuming the likelihood of a missed test after almost 10 years and non "classical" symptoms make this a bit more unlikely to be HSV?

4.) Though recurrences can appear elsewhere, are most still on the penis? How about HPV or MC?

Any other advice or insight you could provide is much appreciated, as if this terrific service.
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
44 months ago
This sounds nothing like HSV to me.  In fact, cortisone makes herpes worse, not better.  But most important is the western blot negative result - that should settle the last of your worries, for sure.  The IgG can miss people's HSV infection but the western blot is excellent. 
What you are describing does sound more like folliculitis to me as well.  Have you had a professional look at these for you?
HPV and MC can show up anywhere in the pubic area - MC like the pubic hair best, in my experience. 
Have you been worrying about herpes for this whole 10 years?

Terri
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44 months ago
Many thanks for your response.

Would hydrocortisone make even a mild HSV OB worse? My hesitancy to believe this to be folloculitis is that it was outside of an are with hair. The first 2-3 were close to hair, but the others were 2 or so inches up. 

I was traveling when I noticed them and was unable to see anyone. And I did not think urgent care would be appropriate. I did post a photo on the First Derm app and they believed it to be folliculitis as well. They never opened or crusted over, they've simply faded and are now almost gone after 7-8 days. 

I wouldn't say I've worried about it the entire time, though it does come and go. I've scheduled time to speak with someone, as I am unsure how to deal with this fear. 

Thanks again for this service, I hope the three of you understand what an impact you are making. 
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
44 months ago
Cortisone is used to control an overactive immune response  But herpes need the immune response to keep it under control so things like cortisone, that take away the local immune response, usually make herpes worse.
If you get it again, urgent care is completely appropriate.  They see a ton of STD's. 
I'm glad you are seeking care to deal with these fears.  They can get a bit out of control. 
I'm guessing folliculitis!

Terri
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