[Question #8229] Open wound on base/testicle

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47 months ago
Hi there , I just now noticed this and am pretty confused. On my testicle (very near the base of my penis).. I’ve just discovered an open wound (the closest thing I’ve found is described as chancroid).. the skin around it is all normal , just underneath the sore is very swollen so it’s like a bump with an open sore in the middle. I have had no sexual contact in 8 weeks besides one condom protected encounter with someone I know well. Before this it had been another 12 weeks since my last partner, never had anything like this. I will say I’ve been treating a similar spot(was scabbed over tho) in my ear with some antibiotic ear drops.. not sure if this could have spread anything? Or what std this could be . I was igg tested for herpes negative a year ago. Only been with these 2 people since. I have no itching or blisters or multiple lesions .. strange and I’m hoping you’ll have some insight. Thank you so much 
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47 months ago
Also to follow up.. it’s not very painful. Burns a bit as I’ve been squeezing and prodding at it a bit when I noticed it. I kinda found it by chance not because it was super painful/itchy etc… maybe just had my hand down there because it felt slightly irritated. Then I felt a bump .. thought it was going to be an ingrown hair or something and saw a pretty deep ulcer (overal it’s small, but when I stretch the scrotum skin out it’s maybe 1cm but pretty deep considering) 
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47 months ago
There’s a hair kind of growing out the side/border of the ulcer and if I tug on it .. seems to be a deep hole that goes down into the wound. 
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47 months ago
The spot in definitely on my scrotum if that was unclear , just nearing the base of my penis, left side. Sorry for all the replies I just want you to have all the info!
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H. Hunter Handsfield, MD
47 months ago
Welcome back, but sorry you found it necessary.

This is not an STD problem. It sounds like a garden variety skin infection, probably starting as folliculitis given the association with a hair. Your description, the location, and the timing with respect to sexual exposures all argue against STDs. In addition, over 90% of genital skin conditions (sores, ulcers, rashes, etc) and other skin conditions are caused by non-STD problems. I suggest keeping the area clean and dry, and checking with a doctor if it doesn't promply heal. There is no need for evaluation for any STD.

I hope this information is helprul and reassuring. Let me know if anything isn't clear.

HHH, MD
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47 months ago
Thanks dr… I will say the hair was like on the periphery of the ulcer.. and the ulcer seems to be a deep , and has what appears to be a sort of narrow tunnel in it. I just went to a doctor who looked at it and said her primary guess was genital herpes, even though she said she’s never seen a single lesion on the scrotum before , just the way it looks. She didn’t seem to change her opinion based on the timing relative to my encounters or the location. “Herpes can show up whenever/wherever etc. she said it could be folliculitis but she definitely thought herpes .. I was Swab and igm tested .. I had to request igg
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47 months ago
I kind of mentioned this but the ulcer is like .. perforated (as in it’s not a totally flat lesion)  ,  and I made her aware of this but she didn’t think much of it .. or the timing of my encounters etc 
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H. Hunter Handsfield, MD
47 months ago
Herpes of course is a common cause of genital ulceration, but your description really doesn't suggest it. Whehter it appeared "perforated" mades no difference at all, and indeed sounds less like herpes than folliculitis or a pimple. You can expect negative results for the HSV tests that were done. But plan on ignoring the IgM test result:  the IgM HSV tests are notoriously unreliable, with both positive and negative results to be ignored.---
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47 months ago
Thanks so much for the swift reply, I don’t want to over play the hair.. as it was on the edge of the wound(but still on the broken skin barley) and it is a typical small ulcer/open wound with swelling.  Can you tell me what about the description has you confident that the result will be negative. I just don’t see how foliculitis could cause an open wound/ulcer.  Definitely doesn’t look like a pimple. Im sorry but im very distressed and the doctor i saw just seemed to matter of fact that herpes was her most likely outcome.. even though the single lesion and location of scrotum (it is upper scrotum tho near the base .. but still definitely on the scrotal skin.
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47 months ago
I know it’s not the best source .. but it does look similar to some mild single ulcer herpes pics online 
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H. Hunter Handsfield, MD
47 months ago
The hair isn't important; it's not the main basis of my reasoning and my reply would have been no different if you hadn't mentioned it. There is simply nothing in your description that fits well with herpes, and as I said the large majority of genital area skin infections are not herpes or other STDs -- and the odds of these are even lower for a lesion of the scrotum. In addition, initial GH lesions typically occur at locations subject to friction during sex. (The virus must be massaged into the tissues for infection to take hold.)

I can't and won't try to challenge your doctor's evaluation, and on that basis herpes must be a consideration. But I'll also point out you give no evidence that you're at risk for newly acquired genital herpes. I remain confident the HSV lab tests will be negative.

This forum is not intended for diagnosis of specific health problems, especially for non STD issues, and we have now had the two follow-up exchanges included with each question and so that ends this thread. Keep working with your doctor. If it turns out that herpes is confirmed by the test results, feel free to return to post a new quuestion to discuss issues of management, partner protection, etc. But please not until and unless that happens:  we are not a resource for in discussion of non-STD genital conditions. In the meantime, do your best to believe and trust this expert opinion and advice.
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