Herpes? Or am I just paranoid?

[crazywithworry]

Hi.

A few months ago I slept with a guy. He had been complaining about razor rash bumps. I didn't really think anything of it. While we were having sex, the condom broke and we didn't notice till the end. Then about 2 weeks ago, I ended up sleeping with this other guy. We used a condom. While he was giving me oral, his stubble was irritating the skin just above my vulva, where I normally shave my pubic hair. It was irritating it so much that I asked him to stop. Three or four days later I noticed a small bump in that same spot, just above my vulva in my pubic hair. It didn't really hurt. I thought it was an ingrown hair. A day after that the bump looked different from the way my normal ingrown hairs look, and it was a little itchy. When I touched it, it broke very easily and a little clear fluid & blood came out, making it an open sore. It didn't hurt much, just tender to the touch. I didnt see any other bumps. I shaved the area around it and put neosporin and a small bandaid on it. The next day I took the bandaid off. I found that I had 4 more little bumps like the first one. And the first bump was now larger and mishaped. It looked a little like a shallow crater with yellowish gunk in it. When I touched the new bumps, they had the same reaction as the 1st bump. It has been four days since then and the sores are still there. The first one is larger (1/4 inch) and the other four are still smaller (1/8 inch). The pictures I have seen online don't really look like what I see on myself. The images show the lesions from the labia to the anus. Mine are located above my vulva in my pubic hair, in the same place where my irritation was during oral sex 2 weeks ago. They are a little ichy every now and then and they only hurt a little when I touch them. It feels like they are tender, not like the razor blade pain that is described with herpes sores. The entire area (size of a quarter) is slightly red and raised, mildly inflamed.

Herpes? Thanks for your time Dr.

[Edward W Hook, MD]

Lymph node swelling is a non-specific reaction to inflammation.  It could certainly be due to herpes or something else in the area of your left leg and groin.  EWH

[crazywithworry]

Hello again Dr. Just wanted to do a follow up with you. My lesions are mostly gone, although the area still itches a little from time to time. Also, I've noticed just this afternoon that my left lymphnode in my groin is swollen and slightly tender. Is this another indicator of herpes? It's a little late, considering my lesions are almost gone. Could it be something else? Thanks.

[Edward W Hook, MD]

The yield or testing goes down as the lesions heal but it still may be worth testng. the health care professional examining you is the best person to make this call.   EWH

[crazywithworry]

Also, how late is too late to get the cultures taken. My lesions are scabbing over for the most part, but is it possible to still get the culture done?

Thanks.

[crazywithworry]

Thank you Dr. I have just a few more questions. Are my symptoms suggestive of HVS 1 or HVS 2 infection? I'm not sure as to what the differences are, as far as symptoms. Also, as far as time lines, is it more likely that I contracted the virus during my first described sexual encounter a few months ago, or the second described encounter a few weeks ago? I woke up this morning to find that I'm on the road to recovery. They look much better. They are still a little pink around the edges, but the inflamation has gone away and the tops seem to have scabbed over (a redish-pink color). Also, the edges of the lesions seem to be peeling a little, kind of like a sunburn peel. They are looking better and will probably be completely closed up by the time a clinic is available. (Tuesday, with Monday being a holiday.) It has been 1 1/2 weeks since the first initial bump. If I cannot get the test done for a few months, what are the chances of me spreading HSV, should I have it?

Thanks again, Dr.

[Edward W Hook, MD]

The lesions and symptoms that you describe are suggestive of an initial episode of herpes.  If the lesions are still appearing or present, I would suggest that you see a health care provider ASAP and get a herpes culture or, even better, PCR test performed on the lesions.  Your lesions also could be any number of other skin conditions including, as you suggest, folliculitis (a medical term for hair bumps) and a health care professional would be the best person to help answer the question.  Another advantage of seeing a health care professional is that, if the lesions look like HSV, at the time they culture you if the lesions look suspicious, they may give you a prescription for an antiviral medication which could shorten the outbreak and promote healing.

A blood test at this time may not be helpful, particularly if this is a recently (last week or so) acquired infection.  It may take 3 to 6 months for a blood test to become positive.  The culture or PCR from the lesions will tell the story.  Hope this helps.  EWH