HSV? HPV? Something else hopefully?

Sexual health
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Short version:

What is in the picture? HSV? HPV? Something else?

I have HSV 1 with sores on or around my lips during outbreaks, but never any sores on my genitals or any symptoms around my genitals.

Long version:

About 10 years ago I (32M) was diagnosed with HSV 1, which is common on one side of my family. During outbreaks I tend to get only 1-2 sores on my mouth or near my nostrils, with OBs occurring about every 1-2 years. I take vacyclovir at the first sign of outbreaks, and in combination with Abreva my OBs are very mild. I have never had any sign of sores or HSV symptoms on my genitals. All my full panel tests for all other STDs/STIs have always been negative.

I am still with the same partner (29F) that I was with when I was diagnosed, and I have been with no one else since. My partner gets tested regularly at the OBGYN, especially when she has an ingrown hair or something like that. As of a August, I have not yet passed it to her. As far as I know, there has been no infidelity.

About 3 weeks ago, I felt the “tingle” on my lips, so I took the vacyclovir and started using the Abreva. I typically still masturbate during this time period, and sometimes have sex with my partner because I’ve never seen any sign of sores on my genitals. During this most recent outbreak I was not having sex with my partner due to her experiencing a traumatic event and not desiring intimacy, which is totally normal and just fine. I mention this because my masturbation frequency was probably 4-5x that of normal, and I was doing things like using moisturizer and personal lubricant to masturbate, which is not normal for me. I have contact dermatitis and I usually avoid lubricants.

I went to a walk in clinic to get tested about a week ago, concerned because the frequent masturbation has caused some irritation that could be early signs of HSV 1 or 2 on my genitals. I was also worried that I may have never been tested in the correct window for IGG to show a HSV 2 infection prior to dating my current partner. The doctor at the walk in clinic was not very knowledgeable, and only offered me IGM and IGG testing. I have received the test results on Sunday, IGM HSV 1 and 2 are both negative, and IGG is negative as well. So I experienced a false negative for IGM HSV 1, since I know I already have HSV 1 from a culture/swab at the time of diagnosis.

Maybe 6 hours ago I noticed a bump on the shaft of my penis. I have attached some photos for reference. I’m really hoping it’s some form of irritation and not my partner or I spreading my HSV 1 to my genitals, or even worse a false negative for HSV 2 because all I’ve ever had are the not so great antibody tests for HSV 2 and never having any sores to swab/culture.

I know that in a few days if the bump blisters, oozes, and scabs that it is a HSV sore. I will get it cultured if it starts blistering, so I will know if it’s HSV 1 or 2 on my genitals. This will help my dermatologist or primary to figure out the correct anti-viral dosing/schedule. But due to all the vacyclovir in my system I’m worried that the bump may not blister/ooze/scab, because no sores on my lips got large enough to scab over during this outbreak. Or hopefully if it doesn’t scab it’s just something else.

So…

  • Is it HSV on my penis shaft or something else???
  • What do I do next???
  • Would a PCR test for HSV make sense???

Any advice is appreciated. The last thing I want to do is give this to my partner, especially since we’ll likely try to have children soon.

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Hsv

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Update:

I called my local Planned Parenthood and was able to get an appointment today. They didn't run a culture of the lesion, but did offer me another a full panel including IGG testing. With this test being weeks since my last vacyclovir dose, the results should not be affected.

The PA there believes that it is a skin condition, probably eczema or psoriasis, and referred me to a dermatologist.

Please go to your local Planned Parenthood or similar before an urgent care clinic. The clinic I went to was listed by the CDC for STD/STI screening, but it was still awful.

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hsv 1

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Update #2:

My planned parenthood blood tests came back already. Everything is negative besides the IGG for HSV 1, which is a huge load off my mind now that I know I don't have HSV 2.

I realize the lesion on my shaft could be HSV 1 that myself or my partner spread to my genitals from my lips, but the lesion still has not acted like a herpes sore. So I'm going to trust the Planned Parenthood PA for now on her assessment. If the lesion starts to blister, ooze, or bleed, I will make sure to get it swabbed/cultured so I know for sure.

I have an appointment with a dermatologist in about a week, which is the earliest I could get. I will post another update at that time or if anything else changes.

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Hello and hope all is well.... How did your follow up turn out for you??