Cold sore or something else?

[Gurleen Hota]

Hi. I got a painful blind pimple on the corner skin of my lip which didn’t change appearance for 2 days. It irritated my skin so I popped it . The moment I popped it, it left a white scar immediately ( hypopigmentation) , looked nothing like a blister. I applied alcohol on it because I thought it will dry it up (horrible decision). The next morning I got up with an infectious with redness spreading all the way to my upper lip , painful (looking like a clotted wound, no blisters again. Went to two Drs , they said it’s herpes (cold sore), gave me anti virals,for 5 days, I just had 3 of them and the infection went away in 2.5 days. Which made me doubt if it was a cold sore. The infection did have a little bit of puss when it was healing but never had a crust or anything. I thought of getting a pcr but there was actually no puss or fluid was to test it. The drs too didn’t bother to ask me for a swab. They flashes light on my face and diagnosed me, which was annoying. The white scar remained my my skin for a month then turned black.

NOTE: My partner has had cold sores since he was a baby. But he got his last cold sore in 2017. Never after that.
Also he gets them on his nose (on the left corner covering his nose). He has never gotten it on the lips.
1. Since herpes is skin to skin (symptomatic/assumption) transmission, can I still get it if he gets obs on his nose (never kissed his nose). I got tested after 5 weeks ,igg was negative. 2. When should I retest ?
3. What about western blot? How much will be the total cost including counselling.
4. Is western blot needed or igg will do?
5. Does my description sound like a cold sore? If no , then can it be a staff infection cause by the popping of the pimple?

[Gurleen Hota]

I forgot to mention what was the exact location of the pimple.. it was on the corner of the lip (no face skin not on the lips , where angular chelitis occurs).

[Terri Warren]

1. Since herpes is skin to skin (symptomatic/assumption) transmission, can I still get it if he gets obs on his nose (never kissed his nose). I got tested after 5 weeks ,igg was negative. 2. When should I retest ?
Yes, you could get it even if he doesn’t have symptoms. You could retest in 3 weeks but remember that the IgG test for HSV 1 misses 30% of HSV 1 infections.

3. What about western blot? How much will be the total cost including counselling.
It usually totals about $450 including the counseling, test itself, blood draw and shipping.

4. Is western blot needed or igg will do?
As I mentioned the IgG test misses 30% of HSV 1 infections.

5. Does my description sound like a cold sore? If no , then can it be a staff infection cause by the popping of the pimple?
Usually herpes infections don’t go away in 2.5 days so I’m wondering if this could be something else. They definitely should have swab tested the lesion

Terri

[Gurleen Hota]

I miss warran , thank u so much for your response it was very kind of u .
The only one thing I wanted clear (which you probably missed in my question) is
I totally agree that cold sores can be transmitted without symptoms , I Know that😊. But my question is If my partner gets coldsore on the nose (extremel left corner of the nose)then how can I get it from kissing his lips ? I have always made sure that I don’t come in contact with his nose while kissing him ? So how can I get it from is nose to the edge of my mouth?
Is it possible.. if he’s nose are has the infected never does that mean his mouth is also infected?

[Gurleen Hota]

Also I’m sorry I forgot to ask one more thing. When I asked the dr how did the infection go away in 2.5 days , she said it’s because of the anti virals. Can anti virals make your first ob disappear before a week ?
Also if I never had sores or blisters or crustingthen why did the doctor diagnose it as a cold sore ? Did they misunderstood the pimple scare as a blister?

[Terri Warren]

Just because he has outbreaks in his nose does not mean that he doesn’t shed orally. He likely does, although without symptoms. The nose and lips are in the same nerve group and the virus could travel down the nerve and arrive at the nose or at the lip, without or with symptoms.

I think it is unlikely that even with antivirals a true primary would last 2.5 days.
The lesion should definitely have been swab tested to determine if this was herpes or something else. Now you are left to do antibody testing to determine if you have HSV or not, but the antibody test yields some false positives, so I’m not sure you even want to do that.

terri

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