[Question #7385] Follow up on Question #7375

3 months ago
Dear Dr Handsfield
In my previous question I mentioned "Also during this time, I have also got some tiny red spots(1-2mm if I were to guess) on my penis shaft. It does not appear to be elevated at all but just a red dot on my skin. This also does not hurt nor itch. This spot goes away in around 2-3 days however after this disappears I notice another one in around 1.5 weeks in a different location. Then it goes away in 2-3 days and then another one appears in around one week in another location. Since one month ago to now, I have noticed 3/4 of these red dots in different locations within this period of time, each one coming after around 5 days-2 weeks after the previous one disappears."
However, recently I also noticed another one of these tiny red spots but it may be a slightly elevated bump now rather than not elevated(maybe I just never noticed it was elevated before because I didn't look close enough). Does this change your opinion on the matter or still the same as before in that its not herpes and I should stop worrying.

Also when I said "Both the different kinds of spots that I've mentioned also don't suggest herpes at all right? " I may have not been clear enough but to clarify I meant both the spots as in 1. the red spots(I mentioned above) as well as the 2. tiny skin coloured slightly elevated bumps with the tiny black dot in the centre(to be honest, it might just be a black dot rather than a bump with a black dot in the centre but not sure due to tiny size). Is your opinion still the same on this matter and that it is not suggestive of herpes at all?

Again, thank you so much for the assistance. Very much appreciated and sorry for seeming to be so anxious.

Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
3 months ago
Dr. Handsfield asked me to take a look at your posts as I answer the herpes questions on this board.
The description of the red dots is not at all consistent with herpes lesions.  And certainly not the elevated bumps with the tiny black dot in the center.  Also, herpes lesions almost always last longer than 2-3 days.  I understand that you are concerned, but I think you can take herpes off your worry list, based on the description of your symptoms.

Terri
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3 months ago
Dear Dr Warren
Thanks for your opinion!! I also have another question.

In regards to Syphilis and HIV, I did the Treponemal Ab(CMIA) test and the HIV 1/2 Antigen and Antibody test and I got the results Non-reactive and negative respectively for those test. Do both of these test definitely rule also rule out all past infection so any infection that I may have acquired in my lifetime. (infection that I got from, lets say 10 years ago) or is it not super accurate. Does the accuracy of the test decrease with time and do the antibodies go away with time?
 I read that syphilis can cause condyloma lata during the secondary stage and I thought maybe the black spots could be condyloma lata. For syphilis, even if its at the latent, tertiary stage, this Treponemal test will still come back as reactive right? Should I 100% trust the test results and move on or do another test?

Sorry if my query sounds strange but I just want to rule out everything and ensure everything is fine. 
3 months ago
Dear Dr Warren
I have another question. For these tiny black dots, when I look at it from the side, it appears white ish so I don't even know what colour it is. I also sometimes have some itchiness near the tip of my penis, sometimes in the tip(inside urethra) and sometimes the foreskin but not where these spots are. My first q is. When you have a herpes sore, is the itchiness associated with it always where the sore is or could it be in other locations as well? I feel like this itchiness isn't associated with herpes but I just want to make sure.
Q2. If I had herpes inside the urethra, would it burn to urinate because I don't get this. Only itchiness at times. Can I rule herpes out?
Q3. Have you ever heard of herpes presenting as what I described (tiny non itchy, non painful black dot when looked from above but kind of white ish when looked from the side that last a few days and also the tiny red spots which have no pain/itchiness and go away very quickly). I am worried I may have an atypical presentation.-> (hopefully I am just overworrying and I'm fine)

Your service is marvelous and I cannot thank you enough for your help


Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
3 months ago
This sounds absolutely nothing like condyloma lata
Herpes lesions can itch yes, but the itching is usually isolated to the lesions. 
If herpes lesions were in the urethra, you would have lots and lots of pain with urination.  You aren't having that so that's good
Nothing that you have described sounds like herpes to me.  I so hope that you can put these worried to bed.

Terri
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3 months ago
Dear Dr Warren
Thanks for your reassurance. 4 days ago, I started to get that same itchiness(which I mentioned) somewhere near my Frenulum and the tip of my penis but can't locate exact area. I had it for like 4 days now and just today it got better. I haven't noticed any blisters or anything but I have noticed some redness(maybe slightly) or maybe thats just how my skin looks. I'm not too sure? I used some eleuphrat 0.05% on it for 2 days and now it is basically better. (maybe slightly itchy but not super). I have had this itchiness before(I think more occurs when I am stressed) which I have similarly treated with eleuphrat or sometimes I just let it go away itself but I have had it like at least 4 times in the past year(each time, I don't really see a blister and when I touch it, I can't exactly find the exact spot it itches, but when I shower and wash it with water from shower hose, I can feel it is itchy. My questions are
1. Does this at all sound like herpes because I'm worried I have an atypical herpes which is itchy. Would herpes sore get better with eleuphrat or does it not actually do anything or make it worse. (When I apply the eleuphrat to that area, it also doesn't sting nor hurt). Could I completely rule it out?
2. Would a herpes sore be constantly itchy because at times, I wouldn't really notice it is itchy(for example, when I am not moving and sitting down) but then other times, I do notice it is itchy. I feel like it is more itchy when I keep trying to scratch it and more itchy when I keep thinking about it.
3. Also I can rule out syphilis and HIV regardless of how long after possible exposure I tested right? I.e Tested 10 years after exposure and got a negative test.

Thanks so much for your help Terri. This issue is really affecting my quality of life as I keep convincing myself that there is something wrong with me. (even though I have got a negative antibody test as well as negative syphilis and HIV test results). I might go get some psychological help after this but right now I am really worried.

Much appreciated


3 months ago
Btw just to clarify for question 2. I meant that when it itches, it isn't always itchy. For example, I mentioned I felt the itchiness for 4 days from 4 days ago till today. During this period, I would have periods when it was itchy then didn't notice the itchiness then it was itchy again so it was rather random but for the most of the 4 days it was itchy especially after I woke up.(Just sometimes I didn't feel the itchiness such as when sitting down)
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
3 months ago
The medication that you describe is a steroid cream (I suspect you are not in the US?) and steroid creams make herpes worse, not better.  I have not real idea what is causing this itchiness but without a lesion and with steroids making it better, I would suspect that it is not due to herpes.  Genital itching is so common!  It just isn't possible over the internet to know what's going on here.  If you tested negative for syphilis and HIV 10 years after a concerning encounter, you should definitely trust that these are not your problems.  If you've had no lesions (sores) in 10 years, my best guess is that the itching is not caused by herpes.  I really cannot provide you any further information about the cause of your itching.

Terri

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