Presentation of pustules/dermatitis around body

[JCDenton]

Evening. I am male. Late January of this year I had kissed and received oral from someone with herpes and contact with the outside and inside of their labia with my penis. I did not ask which form of HSV they had, but I assume it could be genital herpes since they had disclosed. They claimed they were on daily medication, presented no visible sores. No condom was used, and I had shaved the groin area two or three days before.
One week after the encounter (Feb. 6-7) I developed what presented as contact dermatitis, scaly red marks similar to shaving burns. I also developed a sinus infection, drainage and a runny nose. After the sinus infection ended a week later red papules developed sporadically around the groin, inside and outside the thigh region, my buttocks and the upper and lower regions of my back that turned into round pustules, different from my normal pimples due to the entire sore being covered instead of just a smaller white head. When burst they left a sore that took a month to heal. No presentation on the shaft or head of the penis until a week after with small red and flat circles on the head and one pustule on the shaft.
14th the papules that turned into pustules started forming on my nose inside and the crease around it, left ear, throat, chin, and forehead, usually one to two every day. They usually formed near the hairline, eyebrows, and the neck under the ear. Most burst sores are gone, but some of the largest left scars. Developed rash on anus.
Went to the doctor on the 23rd, received 10 days of valstrex (3 pills, 1000mg) and the formation of the pustules seemed to slow down. All STD tests were negative, and the tests for herpes negative for HSV 1/2. Pustules formed slower, one or two on chest and stomach and one on the belt region. Second appointment was March 23rd, negative herpes IGG tests again. No other STD tests taken. Daily valstrex 1000mg once a day starting March 16th.
Herpes, fungal/yeast infection? Both? Burning, itching throughout.

[Terri Warren]

While your symptoms are odd, their locations don’t really fit well with your sexual experience, and the negative IgG test, with the timing, is about as good as it is going to get. If you want to take a better test, the western blot, I would encourage you not to take more Valtrex as longer courses of the medication can confuse the test results.

Has any swab testing been done of these pustules? What do the clinicians that you saw thing is going on?

Terri

[JCDenton]

Thank you for the reply! The 2000 character limit sorta made it hard to explain everything in one go.
My primary physician said to observe it for a time and come back after four weeks to retest (blood test only, no swab) with the second visit after to take another blood test. No additional comments/actions outside of a referral. The dermatologist said the culprit was likely fungal in nature, and believed a swab would be inaccurate as most of my symptoms are clearing up already and wouldn’t catch fungal/herphatic agents accurately. My primary likely gave me valstrex just in case, and the topical cream I got from the dermatologist won’t make any immediate improvements. If it wasn’t for the sinus infection I would have written the symptoms off as fungal folliculitis, but only one or two of the pustules had follicles sticking out of them, out of roughly seventeen. Two filled with blood instead of pus, likely due to friction. I’ve also felt burning sensations on the top of my lip but not directly on the lip itself, and itching/burning in my eyes, face, and groin. Mostly before the pustules pop up, but sometimes with no papules/pustules forming. Whether it’s psychosomatic, prodrome from herpes, or fungal infection is maddeningly ambiguous. One of my partners also developed pustules on her back, face, buttcheeks, and papules between the inner thigh and outer labia. Not nearly as much as I did, or for as long. Her sinus issues are constant so illness symptoms would be masked. No tests on her end yet.
I’ve had chickenpox twice and shingles when I was thirteen, so the pustule popping up on the tragus of my ear was worrisome. Herpes Zoster would not typically present how I had it or spread that well to another person.
Thank you for your time and advice! I feel after a third blood test around the third month mark and the advice given to me by you would more accurately conclude any misgivings I had.

[Terri Warren]

The best thing for you to do is have these lesions swab tested! The swab should be both for HSV and for bacterial infections, in my opinion

Terri

• This reply was modified 5 months, 1 week ago by Terri Warren.

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