[Question #2963] Concerned about herpes due to rash

41 months ago
I am a 33 year old male that recently made a mistake and had a one night stand (unprotected vaginal, no oral) with an acquaintance that I have known for a while. However, I do not know her sexual history or status. I did ask her and she assured me that she is free of any STIs. I am living in Europe right now and this happened in Austria. 

Several days after this exposure, I notice a small (1/2 US dime) red, rash on the right side of the shaft of my penis. It was a bit irritated, but no bumps or blisters. When you looked closely the skin seemed to be wrinkled within the red area. I have been looking very closely at my genitals since this exposure, and am certain that I never saw any bumps or blisters. 

12 days after the exposure, I went to the local dermatology/venereology department at the hospital and had the doctor look at the rash. He did not test the rash for HSV, but looked at it under the light and did not think it was any form of a STI. He suggested that it is dermatitis of some kind and prescribed me with an oil based soap for the shower and a cream to put on it each day. I can still feel that the rash is somewhat irritated when I put the lotion on. Though it does not hurt at all during the day. 

The rash has not changed much in appearance since it first started. I will say that the redness seems to have reduced, but that also seems to depend on the time of day as the redness on the rash seems more apparent than others. Also, if I am erect, it is very difficult to locate the rash at all.

I tested negative for HSV 1 and 2 a year and a half ago and have not been with anyone since. That test happened 4 months after my previous sexual encounter. 

I have been reading far too much about herpes and the many forms it can take. This has really made me very anxious that this could be an atypical/mild primary outbreak of herpes. I plan on getting tested at 6 weeks to see whether I test positive. 

My question is does this sound like herpes? 
If the rash heals in a next week, do
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
41 months ago
This sounds nothing at all like herpes to me.  Nothing.  But it does sound like it could be fungal.  Have you tried anything on this spot?
Herpes would have definitely changed over time- evolving from a blister to an ulcer to a scab.  This has not done that from what I read.  I seriously doubt that this has anything to do with herpes

Terri
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41 months ago
Thank you for the reply Terri. I really appreciate it. I have not tried any antifungals at this point. The doctors report simply stated that the area "appeared wrinkled and most likely dermatitis". He was pretty adamant that it is not sexually transmitted. He subscribed something called Lipobase, which is a stronger moisturizing lotion. I have only been using it for 4 days and the rash appears to be somewhat better, but not significantly. I can still feel some irritation when the skin become stretched. It also does not itch at all. I have not had any other symptoms, such as pain during urination or any swollen lymph nodes. The doctor also asked whether my inguinal lymph nodes were sore. I have another appointment with the same doctor on Thursday. I am hoping the rash will be better by then, but I am nervous that the rash has not healed yet. I initially thought it was some kind of abrasion from friction, but I figured that would heal faster than this. The dermatitis is possible, but I have never had that before. They also did a urethral swab to test for other STIs, so I will find out whether I was infected with anything else in a few days. I guess my reasoning behind herpes is that a mild case could be a minor rash. Also, that herpes can also be confused with dermatitis. I am still planning on getting a full range of tests in mid-December. I will be traveling back the the USA for Christmas and plan on doing it then. That will be 6 weeks post exposure. Thanks again. 
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
41 months ago
I don't believe that herpes could be confused with dermatitis honestly.  They do not look the same at all.  Good that a professional looked at it so you don't have to wonder as much!

Terri
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41 months ago
Hi Terri, I wanted to ask one final question about atypical or mild cases of HSV. Reading online, it seems that rashes, cuts, bug bits, and other mild skin irritations can sometimes be mistaken for HSV. Is it because people usually don't look close enough or pay much attention to their body to recognize that these mild cases are still pretty typical for HSV? Reading online makes you think that any skin irritation can by HSV and I imagine that is why you have so many people that are so paranoids about these types of skin conditions when they happen. I was just hoping to get your thoughts on that. Thanks again. 
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
41 months ago
I do understand that it can be intimidating to read about the atypical cases of herpes and wonder if that might be you. But the thing here is that you have been evaluated by a professional who did not think your symptoms were herpetic and you've written to me and I don't think your symptoms sound herpetic either.  Many people who have these atypical symptoms, I would say most of them, have not been evaluated by professional. Well it is possible that clinicians can misdiagnose something as being not herpes when it is herpes, the symptoms that you describe just aren't consistent with herpes. If you continue to be concerned, I would encourage you to acquire the herpes antibody test. The one you want is either IgG or the herpes Western blot which is the best antibody test for herpes.

Terri
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