worried

[zebedee670]

Thank you Doctor for your valued opinion.  Im a 30 yr old hetero male. no hx of stis. live in UK. started a new relationship 8 months ago. we have both had full stis screen before we became sexually active (herpes not included in UK) although either of us has ever had a herpes outbreak.

6 months ago after using a durex tingle lubricant and having prolonged intercourse developed large (1cm) painless papules which were scattered all over the shaft of the penis. these went away in a day but the skin on my penis started to itch and dry out. 5 days later (no lubricant tis time) woke up after a night of intercourse with the same papules which settled down by lunchtime. for 8 weeks my skin was burning and itching but i had no sores. went to GUM clinic and they could not see anything wrong. saw a dermatologist who diagnosed dermatitis and advised me to use steroid and to stop using shower gels as they may be irritating. penis irritation has indeed settled since stopping using shower gels and returns when i go back to them.  
However 3 months ago I started getting a burning pain on the R side of my scrotum which was followed by pains in my R buttock groin and anterior thigh and occasionally in the calf. i also get occasional similar but milder symptoms on the left. These pains are never there in the morning and get worse after sitting.  I have not had any sores or skin changes.  I have now had these neuropathic + muscle pains for 3 months on a daily basis and have decided to go privately to have type specific HSV IgG tests as i cant seem to get herpes off my mind.

I have not had sex now for over 5 months.

1 Do you think I have an atypical form of herpes?
2 could the initial papules that settled in a day and never blistered/ulcerated 6 months ago have been a primary (in the absence of any other symptoms)
3 could the burning scrotum and muscle pains be continuous recurrences?
4 would you have advised herpes testing
5 what could be causing my symptoms

[zebedee670]

A related discussion, still worried was started.

[Edward W Hook, MD]

You test results indicate the you do not have infection with HSV-2, the virus that causes most genital herpes.  On the other hand, you appear to have HSV-1 infection.  The positive test does not tell you the location of the HSV-1 infection however, if you recently had a lesion appear on your lip it is reasonable to assume that this is the site of your HSV-1 infection.  EWH

[zebedee670]

just one last question dr hook.
i havent had sex for the last 4-5 months
my blood tests came back as follows

HSV1 igg positive at 20
HSV2 igg negative 0.6

with the above history would you conclude that i dont have genital herpes? i think i had a cold sore recently on my lip having not noticed one ever before.

many thanks

[zebedee670]

thank you Dr Hook. God bless you.

[Edward W Hook, MD]

No, these are not sypmtoms of herpes. The discomfort of HSV is not chronic and is typically accompanied with lesions, if not at the same time, within hours of the onset of discomfort.

If I had thought the lesions you described were consistent with HSV, I would have said so.  EWH

[zebedee670]

hi doctor, thanks for that. what about the chronic burning scrotum and muscle pains i describe.  do they sound like herpes?

also, with the lesions that i describe would it be possible to get such large lesions that settled in a few hour without blistering or forming ulcers?

thanks you

[Edward W Hook, MD]

Welcome to our Forum.  The lesions an associated timing you describe would be most atypical for herpes.  I suspect that they are not herpes but they could be a reaction to something you put on your skin (like the lubricant) or some more chromic, non-ST problem like a yeast infection.  I would not necessarily suggest a herpes blood test to sort this out but, should the lesions recur, I suspect you would be well served by having a culture or PCR test taken from the lesion.  

I hope this helps.  EWH