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What Causes Painful Outbreak Of Ulcers On The Abdomen And The Genital Areas?

Posted on Wed, 15 Mar 2017

Question: Thank you for our help. Our 21 yr-old grandson who is currently living with us, has been having a severe ulcerative outbreak on his belly- between his bellybutton and genitals. It is extremely painful, and not getting any better. As this is an embarrassing ting to talk about, he tells his dad-they are without jobs at the moment and on state assistance for medical. He has asked us for help- Emergency has seen him several times but advises him to go to a dermatologist. If you could give us some direction or a description of what he might have, we would be grateful. Many thanks B. XXXXXXX

Answered by Dr. Shuba hariprasad (5 hours later)

Brief Answer:
To check for shingles and herpes simplex infection.

Detailed Answer:
Hello,
Thank you for your query.
I'm Dr. Shuba Hariprasad and will be answering your query today.
Based on your description of the symptoms, I would like to check for Herpes zoster (shingles) and herpes simplex (HSV) infection.

Would you clarify a few things for me, please?
*how long has he had these symptoms?
*is he sexually active?
*are the lesions on one side of the abdomen or is it distributed evenly on both sides?
*is the area generally reddened or sore?
*are these ulcers weepy? Any discharge? If so what colour?
Is it possible for you to attach a photo of the affected area?

I understand the sensitive nature of the problem and your position, however, in order to guide him better I need the Information.

I recommend :
- a dermatologist consult
-a scrape test (of the lesion) can help identify the cause
-blood tests (complete blood count)
-once Confirmed, he will need antiviral and steroid therapy to treat it and help with the Inflammation.
-topical (antiviral ointment) like acyclovir can help
However it is best to get it checked by a dermatologist to confirm and treat.

In the meantime, applying ice pack (wrapped in a thin cloth, leaving the area exposed to air, avoiding pressure (by clothes, undergarments) over the area can help ease the pain. If the sores are not open or don't have any pus, apply Lacto calamine or zinc oxide cream can help to soothe the pain.

Hope this helps. Please let me know if there is anything else I can help you with.
Hope he feels better soon and wish you all good health.

Regards,
Dr. Shuba Hariprasad

Above answer was peer-reviewed by : Dr. Kampana

Follow up: Dr. Shuba hariprasad (14 hours later)

Dear Dr. Hariprased,
Many thanks for your in-depth answer and I will encourage my son to follow through on his consult. In the meantime, I will answer your questions as best I can:
1. symptoms-length of time- better part of a year- growing worse.
2. Yes- sexually active
3. lesions evenly divided on both sides of abdomen
4.Lesions are extremely sore and very red. Appear to be growing new ones
5.uclers are weepy but I'm not sure of discharge color or content.
6.I will try to get our son to take a picture of the area.

Answered by Dr. Shuba hariprasad (8 hours later)

Brief Answer:
Herpes simplex to be ruled out

Detailed Answer:
Hello,
Thank you for the follow up and clarifications.
I do believe it could be herpes simplex.
As it is spreading, please seek help as soon as possible.
It is vital to treat promptly.
This is contagious and can spread by sexual contact. It is advisable for him to refrain from sexual activity till this is confirmed and treated.

Do consider my earlier suggestions. Hope I've helped. Please let me know if there is anything else I can help you with.

Wish you all good health.
Regards,
Dr. Shuba Hariprasad

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Above answer was peer-reviewed by : Dr. Remy Koshy