[Question #6967] I cannot get clear answers

10 months ago
Hello, I am back for a third question. I have been dealing with trying to find a clear diagnoses for months. My previous questions were #6797 and #6868. I am truly at a loss. I have convinced myself I have herpes from my previous partner that tested positive for HSV2. Like I mentioned before. I have had very ambiguous symptoms. As of lately. I am have been experiencing a very minor rash where my butt meets my legs. It happened a month apart. They appeared as red dots such as pimples. I did not squeeze them but one I scratched and it scabbed a half hour later. It was tiny again like a sharpie mark. I had various other marks that never opened or even hurt. They were hard in nature and did strike me as water blisters. During this time I saw two different doctors both were extremely convinced it was not herpes but folliticus or marks from being sweaty and wearing leggings in hot weather. They were all spaced out inches away from each other. I have been off valtrex for a few weeks and tested negative via blood test. I have had two swabs culture not pcr and they were negative. I have been too 7 doctors during this time all convinced what I was experiencing was not herpes.  Most of them explained I had nothing able to even swab and all said that herpes is usually clustered and not so spread out and wouldn't be that tiny even with taking valtrex in the past. 

1. Would all 7 doctors be wrong? I know that majority of doctors are clueless on Herpes from reading others people's stories on forums. 
2. I had sex protected while having this "Rash" Do you think i passed it on. I did not disclose because of how many doctors told me I do not have herpes. I am so scared I did. I cannot stop thinking about it. 
3. I know outbreaks can be minor. Would they be as small as a pin head and occuring every 3-4 weeks. It seems to coexist with my period. That has me greatly concerned.
4. Am i driving myself crazy? many of my doctors seem to think I am going down the wrong rabbit hole. I feel constan
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
10 months ago
'm so sorry that you continue to be worried about having herpes.  You describe yourself as an anxious person by nature and one who can get stuck on a particular issue, so this must be extra hard for you.  Just so you know, this is a very common problem, not believing all the lab work and all the doctors who tell you that you are uninfected.  I do video consults every Tuesday and out of the 12 patients that I see, I would guess that at least one of these has the same issue.  There is usually some trigger for these worries - the most common ones are having had a sexual relationship with someone who has HSV 2 and a false positive IgM antibody test.  For some people, the idea that they could have a sexual relationship with someone who has HSV 2 and they didn't get it themselves seems impossible.  But indeed, transmission is just not as easy as some might think.  I know many couples where one is infected, the other not, and they have been together for 20-30 years, having great sex. You reported having had 8 episodes of intercourse with someone who subsequently tested positive for HSV 2, so you have a common trigger for these worries, right? But you actually had very limited exposure to the virus with these 8 episodes.  And since your partner is likely to have had the virus for quite a while, it is likely that he was shedding less often than someone with a new infection. 
The symptoms that you describe above just sound nothing like herpes to me, but they can be explained with a diagnosis of folliculitis, which you were given, and possibly also a little fungal rash from exercising in the heat. 

Let's review the evidence that you don't have HSV 2.
1.  Negative IgG test for HSV 2
2.  Negative PCR swabs from concerning skin changes
3.  Seven physicians who have seen you in person and don't think your symptoms are herpes.
4.  One nurse practitioner, who specializes in herpes who doesn't think your symptoms are herpetic ( and one of the docs on this board agrees).

I have two suggestions for you to try to help you move on.

1.  If you have trouble with the accuracy of the IgG test, you could get the western blot for herpes which picks up 99.9% of HSV 2 infections
2.  You could see out a cognitive behavioral therapist to help you think and behave differently with regards to herpes.  This is their specialty, helping with these concerns that just can't seem to go away.

Terri




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10 months ago
Thank you so much for your quick reply. I agree with everything you have said to me. Greatly appreciated. I would definitely say this has all been triggering me. I am seeking therapy and have been described zoloft from my pcp. It is not that I do not believe doctors. I just have read so much information about herpes and how most doctors do not know much about it. I know that it can present very minor and be easily mistaken. If I was not over examining my genitals I doubt I would even notice these pimples, lumps, and bumps.  My issue lies that my extended valtrex could alter my testing. I was so afraid of going off of it due to the mental anguish I would have going through an outbreak but, seems silly because I have been putting myself through this since January.  I have no had any PCR swabs only culture. Many of my doctors would not swab due to no open lesions or even any abrasions. I guess i feel like I am a ticking time bomb. Today I found a bump on my labia that is clearly underneath my skin and hard. Not painful at all. and it sent me back into this spiral... I dont think herpes would be painless skin colored bump correct? I know I need to move past this thank you very much for all your insight. 

1. Is it normal to get pimples and little hard lumps on vulva and labia?
2. Does herpes usually present it self as little scabs or does a variety of things do?
3. Would you suggest me stop over analyzing my genitals and only look if something was extremely painful? 

thank you again. 


Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
10 months ago
1.  Yes
2.  I would say a number of things could cause little scabs, especially if you are scratching in the night
3.  I would suggest this, as I think you know I would say. 

Although you are still on Valtrex, I think you were off originally long enough to have made antibodies.  The thing is if you come off now, have a real outbreak, you could have it swab tested right away and if positive, go right back on it.  I personally doubt that that will happen though.  But right now, I think you are just postponing the resolution of this concern and it might be driving you a little crazy.    So to get this resolved will be best for you in the long run, I believe.  You will do what you can do when you are ready, I know.  And I also know that you are doing the best you can with a challenging situation.

Terri
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