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Suggest Treatment For An Outbreak Of Cold Sores On Mouth

Posted on Tue, 25 Aug 2015

Question: I've had an outbreak of cold sores on my mouth. I believe I got infected with HPV-1 from my fiance who suffers from cold sores. I have now developed a purple patch on my penis that I originally thought was due to soreness from sex, but it hasn't gone away. it isn't itchy - really just looks like a bruise. is this genital HPV-1?

Answered by Dr. Dr. Kakkar (2 hours later)

Brief Answer:
Kindly upload an Image

Detailed Answer:
Hello. Thank you for writing to us.

I have taken note of your query and I understand that you are concerned about this purple patch on penis.

Genital Hpv usually presents with growths or skin colored bumps rather than as purple patch.

I request you to kindly upload a clear digital image of the area so that I am able to have a look at it and hence guide you better.

You may upload Images either at "Reports Section"

Or

You mail me images at YYYY@YYYY with the subject of this mail as Attention: Dr. kakkar.

Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr. Kakkar (12 minutes later)

here is a picture. the spot extends under the head slightly

Answered by Dr. Dr. Kakkar (1 hour later)

Brief Answer:
Neither Hsv nor Hpv

Detailed Answer:
Hi.

Thank you. I have reviewed the image.

I think you intended to inquire about Hsv i.e herpes but you mistakenly mentioned it as Hpv in your query? Though both these are STDs but are entirely diffferent.

No. This is neither Hsv (herpes simplex) nor it is Hpv (human papilloma virus). This looks like a patch of either seborrheic dermatitis Or a fungal/ yeast infection.
I suggest you to use a topical steroid+antifungal cream combination e.g Clotrimazole 1%+ Beclomethasone 0.025%cream, twice daily for a few days.

Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr. Kakkar (14 minutes later)

These are the sores on my lips. Might these be fungal as well? I had assumed cold sores as they formed water blisters that had drained and left similar patches of purple. Has also spread under my lips to my chin.

Answered by Dr. Dr. Kakkar (20 minutes later)

Brief Answer:
Is there a history of preceding drug intake?

Detailed Answer:
Hi. Thank you.

I would like to know that did you take any oral drug/ medication preceding these lesions on oral and genital mucosa?

I would like to consider a possibility of drug reaction as well.

Drug reaction i.e Fixed drug eruption, is also a very likely possibility for these oral and genital lesions. This type of drug reaction is common after pain killers, antibiotics, vitamins etc.

Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr. Kakkar (6 minutes later)

I did injure my calf and had to take Tylenol with codine and a muscle relaxer. The mouth sores are recent, but they had appeared about 1 month ago as well. The penis rash similarly had appeared, receded some, and then came back. So I do not believe the initial cause was from any drugs. Though maybe the mouth sores are independent?

Answered by Dr. Dr. Kakkar (25 minutes later)

Brief Answer:
I would suggest a blood test for Hsv 1

Detailed Answer:
Hi.

If this type of reaction i.e oral and genital lesions is happening repeatedly after taking a particular drug then this could very well be a drug related problem. Nevertheless herpes is also one of the possibility for your oral/ lip lesions. To distinguish between the two I would suggest that you take a blood test for herpes i.e ELISA for type 1 Hsv for a confirmatory diagnosis specially considering that your sexual partner is hsv 1 positive. If this test comes as negative then drug reaction would be the most likely cause.

Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr. Kakkar (7 hours later)

If it is drug reaction would that likely be cause of the penis rash as well? That has been around for several weeks or longer. Is that fungal and perhaps not related to the lip sores?

Answered by Dr. Dr. Kakkar (14 hours later)

Brief Answer:
Genital patch could eb either drug reaction Or seborrheic/ fungal in origin

Detailed Answer:
Hi.

Patch on glans penis could be either a drug reaction (FDE i.e fixed drug eruption) Or it could be a fungal infection. It certainly does not resemble genital herpes.

Drug reaction e.g fixed drug eruption can present with a red patch (which may sometimes blister) on glans and it may keep on recurring at exactly the same spot everytime the culprit drug is ingested i.e the location of reaction is fixed, hence known as 'fixed drug eruption' (FDE). FDE commonly affects both oral and genital mucosa and is quite common to drugs like antipyretics, painkillers, antibiotics, muscle relaxants etc
Another possibility is that it is a patch of seborrheic dermatitis Or fungal infection.

I insist on a blood test for Hsv type 1. That would confirm whether the lip lesions are indeed herpes Or part of drug reaction (FDE) to tylenol.

Regards

Note: Hope the answers resolves your concerns, however for further guidance of skin related queries consult our Dermatologist.Click here to book a consultation

Above answer was peer-reviewed by : Dr. Shanthi.E