[Question #7509] Worried

2 months ago
Hi Drs.
I am uncircumcised male in early 30s. 3 yrs ago, I had a few bumps on my penis head after an incident, and got tested for all STIs including HSV IGG and WB tests which were negative (HSV1 IGG and WB were positive). 

I got recently married(did not have any exposure in last 3 yrs)  and had both protected and unprotected sex with my wife(she was virgin) multiple times in last 3 weeks. Around 5 days ago I Saw multiple bumps and redness on my Penis head, some discrete and some in groups of 3-4 bumps. They were very slightly elevated, with a whitehead in some of them. I also see some ‘wounds’ on my foreskin and little swelling on urethra. Bumps don’t hurt when touched, have mostly remained unchanged to my eye(might have seen few new ones). I don’t see any fluid in them, not sure if I missed the weeping earlier and now the whiteheads is the crusting stage. There is some itching on penis head/foreskin for few seconds once every coupe of hours. Also been feeling pain in back on my legs during physical activity. Am really worried- was it HSV all along, or another std which went un checked earlier? Please help.
2 months ago
Also wanted to mention, since the incident 3 years ago, I closely observed my penis head for atleast an year. I had little redness couple of times, which was seen promptly by physicians and swabbed for HSV(I asked for it), and turned out to be negative.

Also had 3-4 bumps on my penis after vigorous masturbation and washing with a stronger body wash around 4 weeks ago, which resolved on its own in 5-6 days. But the bumps I am seeing now are spread almost throughout my penis head and also am seeing some ‘wounds’ on my foreskin which I have never experienced before. Worried since I read rigorous sexual activity can activate HSV . 
Edward W. Hook M.D.
Edward W. Hook M.D.
1 months ago

Welcome to our Forum and thanks for your questions.  I'll be glad to comment.  You don't say precisely how long after your exposure of concern you got your blood tested for HSV but presuming that it was more than a few weeks after your exposure, I see nothing to suggest that the lesions you describe represent genital herpes.  Your testing, both the blood tests results from several years ago as well as the swab test you mention, make herpes very unlikely.  The lesions you describe could be any of a huge number so other dermatological processes.  There are glands present in the area you describe which can assume the appearance you describe, trauma from masturbation or sexual activity can cause irritation, and in uncircumcised men such as you, fungal infections can lead to a variety of different lesions.  At this time, if you are comfortable with my advice, I see no reason for concern or further testing unless the lesions you have noted progress.  If they progress (i.e. grow in number or get larger), then I would suggest asking a dermatologist to take a look to help sort things out. Even then, my level of concern regarding herpes is rather low.

I am not suggesting further blood tests since in your situation, particularly given your previous positive test for HSV-1, the likelihood of a falsely positive test is probably higher than the likelihood of finding out that the lesions are due to genital HSV-2.

I hope this information is helpful.  If any part of my reply is unclear, please feel free to use your up to two follow-up opportunities for clarification or additional related questions.  EWH

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1 months ago
Thanks a lot, Dr. Hook
I had gotten tested for IGG and WB at 6 weeks, 14 weeks and an year later. It had taken me a lot of time to move ahead at that time, but it seems the incident is back to haunt me. Particularly concerned now due to my marital status and timing of the appearance of these bumps. I am no longer in US so don’t have access to WB or swab testing. I consulted an online dermatologist and he suspects balanitis.

I am pre diabetic so was thinking maybe fungal infection but can it cause these bumps and shallow wounds on the foreskin? Also is it possible to develop fungal infection if partner doesn’t have active infection?

Thanks

Edward W. Hook M.D.
Edward W. Hook M.D.
1 months ago
Thanks for the international information. You have been tested extensively and there is no imaginable reason for further testing for genital herpes. You did not have genital herpes, despite the timing of the appearance of the bumps you mention.

Balanitis is a dermatological, non-STI process.it can be caused by fungi and is more common among diabetics.  Your partner does not have to have an infection. The process arises from fungus already present on your body which overgrow.  It tends to occur in moist areas ( such as under the foreskin).  EWH 
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