Hello doctor, It has been six months that I have been getting small red bumps on my penis which come and go and it is always in the same area. I had four events during the last six months. I was afraid of herpes, so I went and got a blood PCR HSV test which came negative (this is after my first encounter with pimples and have not had sex ever since). However, my antibody HSV 1 and 2 were positive. Since I did not have any major symptoms I assumed I do not have herpes. About two months ago I started getting a bump in my pubic area that kind of looked like vesicles. It was not painful or itchy and it went away by itself after 10-12 days. However, it left its mark and again two days ago it came back the same kind. About seven days ago I got a pimple on my penis and two small pimples between the penis and the pubic area. They were not painful however, they were extremely itchy. I let them go and they scabbed by themselves. The one on the penis its the same at usual place but this was the first time that it is actually itchy. I feel like every time the symptoms become worst and worst. It was the first time I saw those two small pimples in that area between my penis and the pubic area. I went and did a swap of it and nothing grew on the culture so it was negative for herpes. And now two days ago I got the pimples (vesicles) that I had one and a half months ago. What is wired for me is the bumps on my penis and between my penis and pubic area. They are all in different stages, the one on the pubic area just started and the other two are in the stage of healing. I am extremely confused and I do not know what else it can be except herpes? Although I still have not ruled out herpes maybe all my lab results were false negative. I am attaching the pictures.
Hello. I have seen the pictures. (attachment removed to protect patient identity).  This is a classical herpes genitalis. A positive antibody test for HSV 1 and 2 substantiates that. The virus causing herpes stays dormant in the nerve cells, causing no symptoms. In most people, the virus becomes active from time to time, traveling from the nerve cells to the skin and causing repeated blisters and sores (recurrent outbreaks). Negative blood, PCR (polymerase chain reaction), HSV (herpes simplex virus) tests do not rule out herpes. The gold standard for diagnosing herpes is a test done on a sore (either a viral culture or PCR testing), and not a blood test. I would suggest an oral antiviral Acyclovir Or Famciclovir for the episodes of herpes. However, if you are having frequent recurrences, you may be a candidate for suppressive treatment.