Question: Hi Dr,

I woke up yesterday and feeling mild itchiness in my penis, I checked it and found the small blisters filled with fluid that I asked about it before and you reassured me that it is not herpes. These blisters always on my penis, it just disappears from one place and appears on another and not always itchy, sometimes the itchiness is not on the blisters themselves.

today I woke with a small red sore on the dorsum part of the penis and it looks like a cut or abrasion and stings. What could this be? is it herpes and if not why it is not herpes?

My last sexual intercourse with unknown woman was in 2011, and I believe I get cold sores on my lips twice in my life. I did a rapid HIV test when I got married the one I discussed with you in my very first question to you on this website but I never did Herpes test.

Photos are attached

Thanks for the reply.

As far as I know that Candidal balanoposthitis affects the glans of the penis only and not the penis shaft, AM I WRONG ?? as you notice in pics 7 and 8 there are small lesions covered by crust on the shaft. Also, I noticed blisters, DOES BLISTERS OCCUR WITH CANDIA BALANOPOSTHITIS AS WELL??

Also, I would like to mention that I applied hydrocortisone 4 times and I felt that It make it worse ( became more painful and looks like cuts or ulcers)


My last part of the question is I need your suggestion regarding the following.I my past until 2012 I had unprotected sex like 3 times with 3 different women. . In 2014 I did a rapid HIV TEST CALLED ICARE BY JAL INNOVATION WHICH IS USAID APPROVED AND YES I FOUND IT WRITTEN ON THE USAID APPROVED HIV TEST KITS AND ALL ARE NEGATIVE. ALSO, MY WIFE DID HIV DUO 4TH GENERATION ALSO IN 2014, 12 WEEKS AFTER OUR MARRIAGE AND SHE WAS IN HER FIRST TRIMESTER AND SHE WAS ALSO NEGATIVE. we also got tested for hepatitis b, syphilis but not for herpes. since marriage, me and my wife had no exposure we are in a monogamous relationship for 4 years. so:

1)DO I have to worry about HIV AFTER THESE TESTS??

2)DO I have to worry about genital herpes??

What do you recommend?

Forgot to mention that I am feeling a mild burning when urinating and my urine is very yellowish. That is why I suspected genital herpes too.

thanks

Actually I took the antifungal, so do you want me to stop now and take valcyclovir? My appointment with the andrologist is on Thursday.

By the way the 2 crust lesions did not start as blisters I do not remember seeing blisters on those 2 areas. (You can go back to the photos and see them)

My 3rd question is for my own information. Does HSV2 even if it is asymptomatic increase the transmission of HIV from males to females??

Thank you

Hi Dr Kakkar,

I went to the dermatologist on Thursday, he checked me and he saw the crusted lesions, however, he told me " I do not think this is herpes". I told him that there were blisters but they are gone and showed him the photos of the blisters and he mentioned that they do not look like herpes blisters especially because they are not painful and not aggregated and actually the blisters did not heal by crusting, the crusts appeared spontaneously and were not preceded by a blister. Even the blister that was just below the glans of penis edge is gone now and it did not crust. It appears as an adhesion( you know the small burning scar).
He examined the ventral part of the shaft and he told me that he suspects Lichen Sclerosis. He asked me if I am itching in my ankles and I said No, however, I used to get small itchy dry patches on my forearm especially in winter and it goes when I apply Vaseline or Lotriderm cream ( Clotrimazole+Betamethasone). And he took a biopsy from the ventral part of my penis.
I asked him if I can get checked for herpes, he told me that there are no active lesions now and the blood test will not differentiate between HSV1 AND HSV2 and since I already got cold sores twice in my life then it will come back positive.

He did not prescribe any medication. I even told him that I take valacyclovir and he told me again that he is not concerned about herpes and to wait for the biopsy. I also told him that I have a urethral pain for more than 2 weeks. Actually, today is the first day I do not feel the urethral pain.

I am writing that to follow up with you and let you know what he told me and if you have any recommendations?

Also, I would like to mention that when he examined the crusty lesions on the shaft of the penis with a lens and light, he mentioned something about pigmentation ( I can not recall what he exactly said) and he asked me if I got psoriasis before and I said NO. However, he did not take any biopsy from the crusts and before leaving I confirmed with him if he still does not consider genital herpes and he confirmed that he does not think about herpes. so I am kinda confused. I understand that he is not considering any sexually transmitted disease and he did not ask me to get tested for any.

thanks

I am totally convinced that these are herpes lesions, however, I have never seen these lesions before and as I mentioned in the first question my exposure was 6 years ago. Anyways, I will treat myself as a person with herpes, what is the treatment to prevent further attacks??

NB: I called the lab and I saw on their website that their blood test does not differentiate between HSV1 and HSV2 and I thought of buying rapid herpes home test but it's has low accuracy and not FDA or USAID approved as the HIV rapid home tests so I will deal with myself as a person with herpes. There is nothing more I can do. If you know a trustable rapid home herpes tedt, please tell me about.
Thank you

Hi Dr,

Finally I did the herpes test( IgG antibody test) and I found out that I am positive for HSV1 and negative for HSV2, however, my wife is positive for both 1 and 2, even though she never had any lesions on her mouth or genitals in her life. And I was surprised that I did not catch the HSV2 since we have been together for 4 years and our intercourse is unprotected. Could this happen that I do not catch it from her?? Also what do you recommend for me to protect myself from getting infected?? You know condoms Do Not protect 100% in herpes as in HIV or any other STD. And at the same time what if I want her to be pregnant ??

Thank you for reply,

I read online that the risk of transmission from female to male is 4% which is not high. And I have heard that there may be no viral shedding at that time so it is not uncommon, that what I read online . I am not a doctor but I am mentioning what I have read.