Hi XXXXXXX
Thanks for your query.
Hope I am able to help you for the same.

I have gone through your pictures and your reports.
You seem to be having recurrent episodes of herpes genitalis. Now herpes presents with recurrent episodes of development of vesicular lesions, which further leads to development of erosions, which are seen as red areas of skin discontinuity.
Sometimes the vesicular phase is very short lived and passes out unnoticed and this is what is happening in your case.
As far as I can make out, you are having these lesions mainly over the left side of penis.
Now in your reports, you have anti HSV 1antibody positive. HSV 1 usually leads to infections involving the areas above the waist although this is not necessary.
You should clean the affected area with lukewarm saline water twice a day and then apply a topical antibiotic cream like mupirocin gel over the area.
You will also need a course on oral antiviral like acyclovir thrice a day.
These are certain things that you should be aware of. Such episodes tend to recurrent. Any kind of physical, emotional stress, fever, intake of alcohol can lead to recurrent episodes. Try to avoid these triggering agents as much as possible. In addition, avoid any kind of contact with partner when there are active lesions.
Such recurrences can occur four to six times in a year and every time they need to treated.

Hope it help
If you have any other query, I will be happy to answer.

Wishing you speedy recovery
Dr Geetika Paule

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Hi XXXXXXX

I can understand your concern regarding your query but there are certain things I want you to be aware about.
The suspected etiological agent in your case is HSV1 most probably.
Now this virus usually causes oral lesions and it is typically spread simply by the kind of social kiss that a relative gives a child. So just anyone can get this transmitted to oral cavity.
You seem to have developed genital lesions due to oral HSV, which is seen in many patients. Such infection of genitals by HSV1 can occur due to oral sex with someone having HSV1 oral infection or through sexual contact. In addition, oral HSV1 is very very common.
Therefore, I hope I have addressed your query now.

Please tell me if there is something else also bothering you.

Dr Geetika Paul

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Hi XXXXXXX

You have to take weekly courses of acyclovir only during the breakouts of the disease. Usually this therapy is in the form of 400 mg tablet thrice daily for a week starting from the first day of the appearance of lesions. And has to be repeated each time there is a recurrence. Timely initiation of the drug helps in reducing further recurrences, so it is essential to take the complete course each time.

And there is no similarity between HSV and HIV. HSV basically causes recurrences which can last for a week's time depending on the treatment. A person is contagious only during the time he/she has lesions.In between, the virus goes and resides in a ganglion. So it has no effect on the overall immune status of the affected person and it does not make the person prone to developing other diseases. So there is nothing really that you should be worried about.

The only thing one should take care is that during the time you have active lesions, you should either avoid any sexual contact or use adequate barrier contraception. As any kind of ulcers/erosions over the genitalia makes a person more prone to acquisition of other STD's including HIV as the chances of transmission from the partner through the eroded area are increased.

Hope that clarifies your query

Dr Geetika Paul

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