Herpes or dermititis?

[015944]

I was tested for hsv2 by a swab test five years ago and negative. I had an ulcer that they later determined appeared to be from a dermatitis reaction. The other day I noticed an ulcer like lesion on my vagina over my hood and went to the doctor. They said that it looks like herpes. I have had no outbreaks that I’ve ever noticed prior to this and no sex partners since the test 5 years ago. Is it possible? I had recently changed laundry soap and also gained a really bad yeast infection, I believe I may have scratched myself in the area of question. additionally I treated the yeast infection with over the counter treatments and vagisil wipes and I’m wondering if it’s maybe just an irritation of that that is caused this ulcer like appearance.

[Terri Warren]

If you’ve had two different thing that ulcerated the genital area, then my level of concern for herpes does rise.
What kind of testing was done for you? Swab test, antibody test?

Terri

[015944]

The ulcer 5 years ago was a small cut which I believed was caused by a g string. It then was continually irritated because of the location but was more anal. Because it wasn’t healing they tested it for herpes and with a swab test. They called me to let me know that the test results were negative.

The test this week was blood and I am awaiting the results.

This started like a small cut but seems to be getting bigger over time.

[Terri Warren]

So no swab testing was done? It should be done! When did you go in to be seen?

Terri

[015944]

Two days ago. The dr. tild me the swab test eas unreliable so she went with blood. She yold me that the one 5 years ago was pprobably wrong because swabs are not reliable.

[Terri Warren]

Your doctor is not up to date on the latest swab tests for herpes. Unfortunate. The new PCR swab tests are four times more sensitive than culture. And the problem here is that if you received oral sex from someone that resulted in genital herpes, then it is likely type 1 and the blood test misses 25% of HSV 1 infections. And if your infection is new, antibody won’t be there anyway! The test you need is a swab test and it should be PCR. I would strongly encourage you to seek a swab test today for this lesion and try to find someone who can do PCR vs. .culture and be certain it gets typed. The antibody test is the wrong diagnostic tool here. It may be useful to establish a baseline results, but is not going to be very useful, unless this is old infection, for this symptom.

Terri

[015944]

Two days ago. The dr. told me the swab test was unreliable so she went with blood. She told me that the one 5 years ago was pprobably wrong because swabs are not reliable.

I have attached a picture both normal and magnified.

[Terri Warren]

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terri

[015944]

I have not had any sexual partners oral or otherwise in five years. I had the last testing after my last partner.

[Terri Warren]

I am very concerned about this lesion. You need swab testing. Can you go to an urgent care clinic for this today? The sooner you get this swabbed, the more quickly you will know what is actually going on.

Terri

[015944]

I went to urgent care. I can try to go somewhere else. Concerned I assume that it is a hsv virus?

[Terri Warren]

yes, concerned that this is herpes. Is there a Planned Parenthood in your area?

Terri

[015944]

I went to planned parenthood as you suggested. The test came back negative as wdll as the blood test from the week before.

Thank you for encouraging me to go get the test.

[Terri Warren]

How long after the outbreak started did you get the swab test? Do you know if it was a culture or a PCR?
Here is my concern. If this is HSV 1 infection, the usual screening blood test misses 25% of HSV 1 infection, so you could be infected and not know it. That’s one our of four. And are you certain they are doing the IgG, not IgM test?
If the swab test used was a culture vs. PCR and you went in even a few days later, it could have missed the infection.
HSV 1 recurs very infrequently and it not even matter that much if you have genital HSV 1, in reality. But this ulcer is concerning.

I’m not trying to make our life difficult, really I am not, I’m just trying to address this confusing situation.

Terri

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