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Have lesion on scrotum, itchy. Had unprotected sex. Have athlete's foot on feet. Applied 70% alcohol. Herpes?

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I have a lesion on my scrotum and am wondering if it is herpes. I first noticed it about 19 hours ago as a mild itch. It is not painful nor does it continue to itch. The picture was taken just now (about 19 hours after I first noticed it). In the past couple of weeks I have had unprotected oral sex (giving and receiving) and have had both protected and unprotected insertive (me doing the inserting) anal sex...all with other guys. I do go to the gym a lot and have a mild athlete's foot infection on one of my feet. The lesion seems to be one about 2-3mm and two adjacent tiny ones. In a panic this morning I did rub them with 70% alcohol and wash the area several times.
Posted Fri, 9 Aug 2013 in Sexually Transmitted Diseases
 
 
Answered by Dr. Timothy Raichle 39 minutes later
Hello, I would be happy to help you with your question.

First a few questions for you:
1. Is there ANY sense that this might have started as a small bump or blisters?
2. Did any of your partners have a recently active cold sore on their mouth?
3. Is there ANY pain associated with the sore
4. Is it draining at all?

Thank you!
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Follow-up: Have lesion on scrotum, itchy. Had unprotected sex. Have athlete's foot on feet. Applied 70% alcohol. Herpes? 15 minutes later
1) I guess it could have, but I can't say I noticed it until it started to itch. When I first looked at them, I would say they seemed more like a blister or tiny bump I guess....that was this morning about 6 or 7 hours after I first itched the area. As you might be able to tell, I have a fair number of bumps (non ulcerated) on my scrotum that have always been there. Also, I often shave there, although I haven't for a while (2 weeks or so I'd guess).
2) I don't know if they did or not
3)Honestly not really. Obviously there was an itch that I scratched, but even when I am tugging and pulling at them to look I don't sense any pain. The only pain I noticed was when I heavily swabbed the area with 70% alcohol....which I guess is to be expected.
4) It isn't now. When I first noticed them I do think there may have been a watery element, but very small.

Sorry for the kind of vague answers! I hope that helps.... XXXXXXX
 
 
Answered by Dr. Timothy Raichle 1 hour later
XXXXX- thank you for the followup clarification- it was not vague at all!

Here are the facts arguing for herpes:
1. The time course from exposure to outbreak fits
2. it kind of looks like a resolving herpes lesion in the picture

Here are the facts arguing against herpes:
1. the partners did not have active lesions
2. the sores do not hurt

If you have ever had a cold sore, you know that they are painful!! Cold sores are also caused by the Herpes virus. And on the scrotum, which is very sensitive, it would have hurt and not itched. My gut feeling is that this not herpes for this fact alone. If it is herpes, it will likely recur at some point in the future and then you will have your answer. The only other answer is that it was related to some ingrown hairs or injury from shaving a couple of weeks ago.

I hope that this helps- please let me know if you have other questions and I will answer by the morning!
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Follow-up: Have lesion on scrotum, itchy. Had unprotected sex. Have athlete's foot on feet. Applied 70% alcohol. Herpes? 7 hours later
Thank you Dr. XXXX. At the point the lesion is now, would there be a way to do a swab test, or is it too late (it's not draining anything)?. Would you recommend an antibody blood test? I realize this would only tell me if it was a recurrent outbreak.
Thanks again.. XXXXXXX
 
 
Answered by Dr. Timothy Raichle 6 hours later
You are very welcome.

I believe that it is too late to get a reliable culture at this point. Usually this is most accurate when there is a blister that you can rupture and get fluid from.

The other option is to do the following:
Have HSV titers drawn now and AGAIN in 3 months. If you are negative now and positive in 3 months, then it was probably herpes. If you are positive now (for IGG antibodies that signify longer term exposure), then you were positive before this sore appeared and would support the idea that it was a recurrent outbreak. If both blood draws are negative, then it was not herpes.

Let me know if this helps or if it just made things more confusing!
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Follow-up: Have lesion on scrotum, itchy. Had unprotected sex. Have athlete's foot on feet. Applied 70% alcohol. Herpes? 12 minutes later
Makes complete sense....thank you again, you've been a real help! XXXXXXX
 
 
Answered by Dr. Timothy Raichle 57 minutes later
It has been my pleasure - good luck sorting this out!
Above answer was peer-reviewed by
 
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