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Had protected sex with a parter having genital herpes. Redness appeared on penis. Any risk?

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Dermatologist
Practicing since : 2006
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Dear Doctor, have been in reationship for 7 months with woman with genital herpes. I've wore condoms the whole time even during foreplay and sex for 5 weeks when she had an outbreak. Just recently 12 days post protected sex, 3 small areas just below the head of the penis were reddish purple and mildly pruritic and non-painful without blisters. Have had for 5 daysand it's smooth and discolored only. I may add that I've been on trimethoprim sulfa the last 6 days for Upper respiratory infection. It doesn't appear to be herpes and I was blood tested in mid- XXXXXXX for hsv2 as a precautionary measure. Dr. Could this be genital herpes, balantis, or an allergic reaction to trimethaprim sulfa?
.Thank you for your time Doctor
Posted Sat, 11 May 2013 in Skin Hair and Nails
 
 
Answered by Dr. Kalpana Pathak 2 hours later
Hi,
Thanks for writing to us.
I have gone through the detailed history provided, it does not seem to herpes genitalis. However as you are on a sulfa drug, there is a possibility of fixed drug eruption or drug rash. If it is a drug rash, then treatment requires discontinuation of drug and applicatin of steroid cream for few days. Also this points towards you being allergic to sulfa drug and in such cases, the drug should not be taken again
Another possibility could be lichen planus.
Dermatology is completely a visual field. I would be in a better position to help you out if you could attach an image of the concerned area.
Hoping to hear from you soon.
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Follow-up: Had protected sex with a parter having genital herpes. Redness appeared on penis. Any risk? 17 hours later
Doc,
On my question, the wording was not accurate.What happened for 5 weeks was that there was NO SEX during her outbreak and I waited 5 weeks. Now,I have taken sulfa in the past for URI without this side effects. Currently, it hasn't changed nor gotten worse. There's a linear slightly dark red non pruritic line and mildly swollen about 1 inch on the foreskin about 1/4 inch below the head of the penis directly 1 inch lateral to it going to the left as your sitting is a small dime size coalescing red area. Since this started on Sunday, it occassionally has very mild itching which is gone as soon as it arrives. It seems to itch a little more with an erection. Both the dark red area seem to be at the base of the foreskin going posterior to anterior. I will be more than happy to send you a picture if you tell me how to do this on this site. I can e-mail you a picture if that works? Let me know, and once again, thank you for your time Dr.
 
 
Answered by Dr. Kalpana Pathak 12 hours later
Hi,
You can upload the image by clicking on upload image/ report icon or you can send it to YYYY@YYYY and mention ATTN: Dr Kalpana Pathak in subject line.

Regards
Above answer was peer-reviewed by
 
Follow-up: Had protected sex with a parter having genital herpes. Redness appeared on penis. Any risk? 16 hours later
These are a couple of the pictures. It's a purplish red ( not evident on picture) and is peeling a little bit and is only mildly pruritic on occassion. There's a smaller version just right of the this one which is not evident on the picture. We have stopped the sulfa antibiotics at this time and on keflex right now for uri. Not a big deal but overly concerned about hsv-2 which it doesn't appear to be.I know I have to wait up to 26 weeks for an hsv-2 blood test. When the finger is ran over it, you can tell it feels just a little different than the normal skin and maybe a little rougher. I apply an antibiotic/antifungal/steroid cream to the area every 12 hrs. Could this be a flat genital wart? I know there's no test for HPV for men and I don't even know if I'm at risk or even have it, but the statistics of this disease scare me. I wear condoms at all times and I haven't had one break, and maybe I'm just overly concerned but I know that even with condoms that genital herpes and warts still have a small percentage of being passed. I thank you for your time and cooperation Dr.Pathak
 
 
Answered by Dr. Kalpana Pathak 30 hours later
Hi,
Apologies for the delayed response.
Let me assure you about two things, you are probably not having any STD neither the description points towards wart nor herpes simplex. As your GF has herpes, there is nothing wrong in getting HSV serology done because when a partner has herpes, one should exercise caution. Abstain from physical contact during the phase of active lesions. Avoid oral sex. Even when the partner has no lesions, a person having herpes sheds virus and hence one should wear a condom during "No Lesion" phase too. With time this viral shedding decreases.

Herpes lesion usually presents as group of blister but when the lesion become recurrent it may present as a red rash which might be itchy with tingling or numb sensation.

Now coming to your present lesions, unfortunately I can see nothing in the images attached. Either lesions are too mild to be seen in a pic or the image attached is not clear.
Sometimes due to friction during masturbation or friction from clothes, due to application of dettol or soaps, fungal infection etc mildly itchy scaly lesion may occur. To be on the safe side, it is good that you are taking an alternative of sulfa drug. You may continue with steroid antibiotic antifungal combination. But I would advise that you consult a dermatologist too as a naked eye clinical examination would definitely help in reaching a possible diagnosis.

Hope I proved to be of some help to you.
Regards
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