[Question #4542] herpes

27 months ago
I am a male and a month ago I was found negative for HSV 1 and 2 from a blood test and quite happy about this.
Two days ago I developed a cluster of 4/5 pimples/blisters on my right frontal thigh that after popped left lesions/ulcers.
The lesions again are not on my inner thigh and about nine to 10 inches from my genitals. No lesions on my genitals or anywhere else.
This if the first time I've ever had anything like this and as  I said a month ago I was found negative for HSV 1  and 2.  
I have no rash or associated symptoms such as flu like symptoms etc. Dermatologist took a biopsy to rule out herpes or shingles.
Could this be my first outbreak of herpes on my thigh? 

Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
27 months ago
So what kind of blood test was done, IgM or IgG?  The IgM is terrible at picking up infections and also has many false positives.  In addition, the IgG test misses 30% of HSV 1 infections compared to the western blot antibody test.  So yes, these blisters on your thigh could be herpes and indeed sound like they might well be herpes.  A biopsy?  Are you sure it isn't a culture or PCR swab test?  Whatever it is, please call and be absolutely certain that if positive, it is typed (type 1 or type 2).  If it is herpes simplex, you could have missed the first infection that would likely have been genital or anal and are only witnessing a recurrence at this time, on the thigh.

If you wish to post the results of the lab work here for me, feel free and I will help you sort it out

Terri
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27 months ago
The test being done I believe is a swab and a  prior test 6 weeks ago was an IGG. It sounds like your theory is that it is likely herpes. You are saying that this may not be my first outbreak, but rather prior outbreaks where possibly and likely missed.  This is because it would be rare for a first outbreak to present on the frontal thigh? I hear that herpes if on the thigh, typically presents on lateral portion, due to the connection to innervated nerves. Additionally,  you are not sure other alternatives seem likely?    Are there other possibilities that would make sense from what I have reported?    If not please explain. I obviously am rooting for another possibility but of course appreciate your educated and realistic opinion.  My mom currently has shingles and but not sure this is relevant considering i've had the chicken pox.
27 months ago
okay so I got back another IGG test that was negative for HCV 1 and 2 but even if I have an active outbreak this may not be a false negative if this if my first outbreak?  does the test really tell anything if this is first outbreak. still waiting on swab test. thanks and hope to hear from you.
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
27 months ago
Did you get the results of the swab test back? 
I think you mean the HSV 1 and 2 were negative - remember that the IgG test misses 30% of HSV 1 infections so even if you test negative for HSV 1  by IgG down the road several weeks, you could still be infected.  The test I would like to know about is the swab test - I believe you mentioned that they took one?
I don't think the shingles is relevant but the swab test ordered (or biopsy) would like be looking for that as well.
And yes, the antibody test could be a false negative for either HSV 1 or 2 if you are early on with infection
Other possibilities would be staph or strep - was anything bacterial collected, do you know?

Terri
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