[Question #840] Red rash on chest now back

51 months ago
Hi experts 

Little bit of back ground. Back in the dating scene and just trying to enjoy life. Hung out with a guy May 28th, he ended up kissing my chest/breasts. We didn't make out and no sex oral sex or anything. Just kissed all over my chest. June 2nd a few days later went out with another guy and we ended up making out as well as him kissing on my chest and breasts) again no oral sex or sex with him or hand stuff. Pants complety on. Sunday I noticed a rash kind of appearing on my left breast area. I would describe it as a diffused red rash that is slightly raised. About 3 inches long and one inch wide.  Few days later a quarter sized one appeared on my back.  No blisters or open sores and not really painful. No tingling of any sort just very itchy. Went to my doc and they started to treat it like a fungal / contact dermatitis. Continued to itch and today I went to the dermatologist. She took a biopsy because nothing such as shingles or herpes really jumped out at her. I did a photo shoot last Saturday and this second guy had dogs. Maybe poison ivy as well. She couldn't officially give me an answer hence why we did the biopsy. I have had the chicken pox before, no history of hsv of either type. However I have kissed some guys within the past few months. None with viable cold sores. Is there any concern for HSV 1 or 2? I thought I was being safe and just kissing. I am protective of myself and this has me worried.  I have to wait till Monday or Tuesday for the biopsy. Needed to ask if HSV 1/2 was even an option. I did see a patient last week who had just had shingles. I did however gown up. Any help is appreciated. Thank you. 
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
51 months ago
It sounds to me like you did an excellent job of being sexual but very safely.  The rash that you describe certainly does not fit with a herpes presentation - first, I would expect some blistering rather than just a red streak and second, I wouldn't expect it to go around the back as well.  The biopsy should give you good information, however, it isn't always the solution either.  Let's see what it says and go from there.  But in terms of it being herpes - I doubt it.  Nothing here suggests herpes to me.  Try to have an enjoyable weekend and when you get more information, do let me know, OK?

Terri
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51 months ago
Will do. Thank you. 
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
51 months ago
You're welcome

Terri
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51 months ago
Hey Terri 

The dermatologist medical assistant said the biopsy came back as a form of herpes. the actual doctor said she would be calling me around noon my time. I'm kind of freaking out right now. On my chest and back? Could this be HSV 1/2? Esp worried about 2. I didn't think something like this could happen on me chest. Again there was no genital contact at all. I had kept all my clothes on except part of my tank top and no one was unclothed on the waist. Does this sound more like shingles ? Help  please I'm not sure what to think or do. 
51 months ago
I'll mention That there has been a little pain that has developed and it's been sensitive 
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
51 months ago
Perhaps it is herpes zoster - shingles?  I am not aware that if it is herpes simplex that typing can be carried out from a biopsy.  And I believe a biopsy might show a particular kind of cell associated with the herpes viruses, but I'm not aware that it can separate shingles from simplex, but let me know what the biopsy says.  I will keep this thread open so you can fill me in, OK?

Terri
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51 months ago
Thanks Terri for keeping it open. The nurse called and said the diagnosis is herpes folliculitis. Which is caused from Zoster or Simplex. The actual dermatologist is calling me at noon. Again this is presenting on my chest above my breast and on my back. I'll let you know when she calls in a couple hours. But any concern for HSV-2? I have been negative for both with lots of testing over the last years. I am not promiscuous so as you can see I am very concerned. 
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
51 months ago
I would not worry about HSV 2, here.  If you've been testing negative by IgG, then I consider that more definitely than a biopsy.  And I don't know what herpes folliculitis is, actually.  Try to get a copy of your actual test results - perhaps they will scan and send it to you.

Terri
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51 months ago
Spoke with the dermatologist. Pathology report cannot determine if it's zoster or hsv. There weren't any blisters to culture. I got red bumps for the first day which apparently was folliculitis. She told me to get a herpes test in a couple weeks. From what I've read it's best to get it at 12 weeks? In my case what would be the earliest you would suggest to me? Think it's even needed? I haven't had sex or oral sex since my last monogamous relationship. I have made out with some guys though  within the last 6 months. I am most concerned with HSV-2. You mentioned it doesn't seem like that - if it was would I shed from my chest? Just doesn't seem like that's it from the things I've read on your past answers with others. The dermatologist also said the rash presents in the front on the same level it doesn on my back. Terri even if it was hsv-1 wouldn't it be on my lips? That's another reason why the doctor said she's leaning more towards shingles. Any insight would be helpful. Just trying to understand how making out has got me so worried. 
51 months ago
Forgot to mention I also had severe arm pain the day before the initial rash took place. Again hopefully shingles? 
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
51 months ago
I am most definitely leaning toward shingles - I have never heard of herpes simplex going around from chest to back.  The PCR swab test would have told us if it was zoster or simplex or neither.  I think HSV 2 is extremely unlikely.  Have you ever been tested for herpes 1 and 2?

Terri
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51 months ago
Yes I have. A few times. Negative on both. Haven't been sexually active since January (my boyfriend and I broke up in January ) and I have not engaged in any sexual activity beyond kissing. No hands down anyone's pants or vice Versa . I've made out with a few guys (always look for cold sores) and again this last guy he has his boxers on and I had my underwear and spanex leggings on. He was on top of me making out. I don't recall his penis coming out at all. I sure as heck didn't touch it with my hands. If It  did pop out my clothes are a sufficient barrier I'm guessing ? (There was no grinding) I am very protective of myself and this has happened and really worried me. Apparently the pathologist says zoster and simplex look the same under the microscope. Thoughts ?
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
51 months ago
What they see under the microscope is something called multineucleated giant cells.  These could be present because of either one (or other things as well).  The PCR swab test would have been the test to do to distinguish between HSV and zoster.  I think zoster.

Terri
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