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Dr. Andrew Rynne

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Got rash after unprotected sex. Diagnosed with lichen planus. Weak positive HSV in test. Herpes?

Answered by
Dr. Rakhi Tayal


Practicing since :2001

Answered : 13394 Questions

Posted on Fri, 1 Feb 2013 in Sexually Transmitted Diseases
Question: I was diagnosed with Lichen Planus in 2009. I had unprotected sex with a female in 2009 and soon after I developed a rash or sore on my penis. My doctor ruled out Herpes, but did not do any tests. He referred me a dermatologist, who ruled out Herpes. She did a biopsy and told me that it was Lichen Planus. I recently went to a new doctor, who I asked to do a blood test. I just got notified that my lab results show that the HSV antibodies were a weak positive or equivocal(can be sore related). I am not sure what that means since I never have cold sores. I had a herpes test in 2000 and it was negative. Since I got a weak positive, I am questioning my earlier diagnosis. Is it possible that my dermatologist is wrong and I do have herpes?
Answered by Dr. Rakhi Tayal 46 minutes later
Thanks for posting your query.
Skin biopsy is one of the surest way of diagnosis. The diagnosis of your dermatologist seems to be right. An equivocal or a weakly positive test for HSV is not always associated with an infection. You can get IgG and IgM antibody test done for HSV-2 to confirm about the infection.
HSV-2 infection is not always associated with symptoms like cold sores. It may remain asymptomatic or dormant for years.
Hope this answers your query. I will be glad to answer the follow up queries that you have.
Please accept my answer in case you do not have further queries.
Wishing you good health.
Dr. Rakhi Tayal.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
Follow up: Dr. Rakhi Tayal 1 hour later
Thank you for your quick response. The first test I mentioned in 2000, I received the lab report that said I was negative was IgG. My recent test, all I got was a letter from my doctor. I have a call in to the nurse to find out what test did you use to come up with a weak positive. You mentioned that I can get IgG and IgM antibody done for HSV-2. I had asked for a test for herpes. Do doctors routinely run what you mentioned when testing for HSV? The way my doctor explained it to me was that a blood test would only tell them that I have the antibodies, but not positively if I have HSV-2. I hope I am making sense because this is new to me. You mentioned that the skin biopsy is the surest way of diagnosis. So what you are saying is that if they would have been able to see that I had herpes, rather than the Lichen Planus.
Answered by Dr. Rakhi Tayal 2 hours later
Thanks for writing again.
Generally we do not do an antibody test - IgG and IgM to test for herpes. You will have to ask for the specific antibody test to be sure.
Skin biopsy is the surest way to diagnose lichen planus. It is not helpful in detecting herpes infection. For that, a blood test for specific antibodies is necessary.
Hope my answer is helpful.
Do accept my answer in case there are no further queries.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
Follow up: Dr. Rakhi Tayal 2 hours later
Hello again,
Since I was diagnosed with Lichen Planus in 2009, is it also possible since I had a weak positive for HSV, that I could also have Herpes also. I have not had any sexual contacts since I was diagnosed with Lichen Planus, so it would be impossible that I was could have been exposed during that time period. As I mentioned, I tested negative in 2000 for Herpes. I did have sexual experiences between 2000 and 2009. Is it possible that I might have been exposed to Herpes and had no symptons? Is it possible that I could have had a false negative in 2000 and I was exposed prior to 2000? I know you mentioned that it could be dormant for years.
Answered by Dr. Rakhi Tayal 16 hours later
If you had no sexual contact after 2009 then it is possible that you are having an infection since then or prior to it. But before this, you must confirm the present status of infection by doing appropriate tests.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

The User accepted the expert's answer

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