HSV 2 on Arm

[Cantbelieveit2022]

In December I developed a blister on the underside of my upper arm close to my arm pit. At the time the urgent care diagnosed it as shingles and I was prescribed the antiviral treatment. Fast forward to May and the blister came up again. Dermatologist then diagnosed it as a cold sore since it was reoccurring and prescribed me antivirals. A couple weeks later, I then took one of the at home blood tests to confirm if hsv 1 or 2 and the IGg results came back positive for hsv 2 (over 7 which said indicates a recent or ongoing infection) and negative for hsv 1. I have never had a cold sore and was negative for hsv 2 before I started a committed relationship in October. He never disclosed anything but oral HSV 1 positive status but I believe I got it from him. Luckily, I have no sores on my genitals or mouth. I know I must now be super careful not to spread this to other parts of my body. But how do I avoid it when it can be spread when no blister is present? Can I spread this to someone else through my genitals or other non impacted areas of skin even though the single lesion is on my under arm? How can I best protect my daughter and family from getting this from me? I’m devastated that this has changed my life forever and how I have to interact with my daughter.

[Terri Warren]

First of all, we don’t know that the symptoms on your arm is HSV 2. It may well be, but that is quite an unusual place for an outbreak of HSV 2. We know that 95% of people who test positive for HSV 2 have it genitally, at least. That is true even if you’ve never had a genital outbreak. We can’t say for certain that this is genital, with a 5% rate of not being genital, but the CDC recommends that you assume you have genital infection and treat it as such.
Also, the HSV 1 antibody test misses 30% of HSV 1 infections, compared to the gold standard western blot so we can’t know for sure that you don’t have HSV 1.

My advice would be tha next time this shows up, have it swab tested using PCR and typing. Then you will know for sure if this is HSV 2.

Lesions that appear outside of the genital and oral region to do not shed virus when symptoms are not present so you don’t need to worry about infecting others when you have no sore present.

Terri

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