[Question #2705] Oral HSV2?

43 months ago

Hi. Previous GF had protected condom sex over 3 months. Only once unprotected oral. She found out HSV2 positive.I Became critical of every bump. I noticed 5 or 6 razor bumps (no blisters/clusters) on upper edge of pubic hair after shaving, lasting 7 days. 4 days later noticed flat red skin rash fingerprint size from left & right mustache area with couple zit like bumps lasting 6 weeks. Got ‘zits’ swabbed doctor said didn’t look at all like HSV. No other symptoms, pain, fever, aches etc. Swab negative. No recurrences on face. Pink rash stayed permanently. Was using $1 razor & shaving cream I remember having a reaction to before & stopped using. Sometimes get a red bump (size of eraser head) in pubic hair region but have had bad buttock acne and red bumps on my thighs since childhood. Have never had any bumps on penis or lips. Worried i might have it & passed to her 4 yr old as every bump he gets on face I think it could be (has nothing more than a pimple for 3 or 4 days the odd time). How do you tell a pimple from a herpe?


5 months later GF got weird sore on corner of mouth, no cluster/blisters/crater-ulcer/pain/fever.  Sore size of an M&M symmetrically round to oval. Then every month or so couple on cheek, then one on forehead, then under nose, then on nose, now big one on chin. Lasts a week or two, first to last one same duration. Look like when scrape knee & after initial blood goes away & healing, gets that moist yellowy flat healing stage before scab but these don’t scab, just shrink & disappear with brown scar. She’s on 6 chronic pain related meds & under crazy stress, depression & anxiety. Your colleague Dr. Hook wrote oral HSV2 is rare & recurrences very infrequent. She’s had 7 of these popup in 7 months with biggest one just happening now.  Is this likely oral HSV2 & if not, do you know what other condition it could be? Thank you.


Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
43 months ago
I totally agree with Dr. Hook that HSV 2 orally is quite uncommon and rarely recurs, when present.  Has your girlfriend had these circular lesions swab tested for herpes?  I know you had something swab tested, but has she?  If not, she should, at the very beginning of one of these, have a test called a PCR swab done of the lesion - far more sensitive than culture.  Also, about her HSV 2 diagnosis - exactly how was she diagnosed? Swab test, blood antibody test?  If a blood antibody test, can you have her look at her results?  If should be an IgG test (never IgM) and the value should be greater than 3.5 for accuracy.

Terri
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43 months ago

I've just done a swab, not her. I'm Worried sick I’ve acquired and infected loved ones.  I know should get test done for her no matter what. I’m just confused, I was told by three separate health professionals that none of my symptoms examined, tested and described are HSV2.  Hoping you can clarify a few things


1. Can oral HSV2 move all around the face including near the top of the forehead? Blemish has never been in the same spot and never been on any of our lips. You mentioned somewhere else that first episode is usually on the lips and you typically get around the same area. What would cause HSV to move everywhere on the face and never on the lips?


2. I’m freaked out whether positive or negative that every single red bump on body could be HSV2 but Dr. Hansfield wrote that even atypical symptoms still go through the typical stages.  What should you look for to distinguish HSV2 from a zit,pimple, irritation, bug bite, ingrown hair?  If the blemish stays the same throughout its duration and doesn’t go through different stages is it likely not an HSV2 symptom?


3.  If someone had an HSV sore is it the sore that is contagious as well as the saliva inside the mouth or just the sore? So if you if you never had a sore on your lip but one on a cheek could you spread it by sharing a glass of water? You mentioned certain areas shed while others don’t because the skin is too thick, is it mostly lips and inside mouth and penis/vagina that shed as opposed to thighs, buttocks, and other areas on face?


4.  Finally, is it safe to say that if somebody had an HSV2 blemish that afterwards it will heal up? Just trying to figure out if permanent pink/red thumbprint light rash on my upper mustache area can be ruled out as oral HSV2 as it has not gone away in almost 12 months.


I’ve been told by multiple medical professionals my symptoms are not at all like how HSV looks and acts but just want to be fully educated and make sure I'm not putting anybody at risk. Thank you kindly.


Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
43 months ago
1.  No, that is not at all what herpes presents like facially.  almost everyone who gets new infection gets it on  the lips.
2.  HSV lesions often start as a red area, form a water blister or more often a group of water blisters, becomes an ulcer, then scabs then goes away.  Usually last 4-14 days. Herpes lesions definitely change over the course of an outbreak
3.  Herpes is not spread through a glass of water.  and correct, thick skin areas do not shed virus
4.  Herpes does not last 12 months and HSV 2 is rarely oral.

Terri
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43 months ago
Thank you for the clarification.  Just one follow up on transmission.   Every write up says HSV is spread from skin to skin contact.   

1.  So if a sore was present say on somebodies lips and they kissed another persons shoulder for example would the cold sore virus be transferred through the skin on the shoulder or does there have to be an opening on the skin and massaged into the skin?  So just touching any part of the body can pass it?  Is it typically only  transferrable in thin skin areas like lips and genitals?   

2.  If somebody has an HSV blister NOT on the lips is the Saliva contagious on the lips even though no sore is there?  
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
43 months ago
1.  No. The shoulder, unless it has a break in the skin, has skin that is too thick for virus to penetrate.  The virus is transmitted to thin skin areas - mouth, genitals, anus.  Once the infection has been established, recurrences can show up on areas of thicker skin, like buttocks or thighs, yes.
2. If you are asking if people who have HSV orally can transmit virus when they have no lesion present the answer is yes, through asymptomatic viral shedding.

Terri
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