Brief Answer: I believe this is HSV-1 sir Detailed Answer: Hello sir and welcome. Thank you for writing to us. Unfortunately the images have not been added to our discussion sir. If you do not mind, please attempt to do so again, so I can view your images as requested by you. Based on the description provided, this does sound like herpes sir. Although you should know that it can take several weeks for HSV antibodies to detect in your blood. So a false-positive (which could be your case sir), does not mean you do not have the infection. Especially when tests are conducted when the lesions are healing. The best time to test is when the blister appears or is appearing. It is also important to note the type of HSV with the type of transmission. HSV-1 is transmitted to the genitals through oral skin cells, and HSV-2 is transmitted through vaginal or anal contact. As the individual you had contact with has HSV-1 and you had unprotected oral contact, it is quite possible that she has transmitted the infection to you sir. No other medication will help sir, and I believe this is herpes itself, not any other infections. But other possibilities that can present in a similar manner are: -Candidiasis (which you have been prescribed anti-fungal medication for) -Syphilis -Hand-foot-and-mouth disease -Herpes Zoster -Chancroid It is unfortunate that at 11.5 weeks your test still returns negative, but I believe it is best to start treatment for HSV-1 at the earliest, based completely on clinical presentation. I hope you find my response both helpful and informative sir. Please feel free to write back to me for any further clarifications, I would be more than happy to help you. Best wishes.

---

Brief Answer: Herpes not ruled out; other causes listed sir Detailed Answer: Hello once again sir. All the facts stated by you are right. Although, in your primary query you stated having presented with a blister which you popped yourself. This appearance of a blister points towards herpes. Also, as you already know, that most accurate testing results only after 12 weeks of the infection contraction, and most of your testing has been conducted only till 11.5 weeks. So we still have to test after 12 weeks, to completely rule out herpes sir. These facts still point towards herpes sir. But after looking at the attached images, a few other conditions come up in my mind, but I cannot confirm which one could have caused such a presentation, as all of these conditions can present in a similar manner. Let me list them out for your reference sir: -Dermatitis (types: contact, seborrheic, atopic) -Psoriasis -Vitiligo -Bacterial infections (eg. streptococcal or staphylococcal infections, erythrasma, etc.) -Fungal infections (eg. Candidiasis, tineas) -Hidradenitis Suppurativa -Human papillomavirus (HPV) -Paget's disease You will have to meet an infectious disease specialist and a gastroenterologist, who will examine your anal region closely and request for a few investigations, which will help diagnose the cause accurately sir. I hope this helps sir. Please do not hesitate to write to me, I am always available to help. Best wishes.

---

Brief Answer: Very good queries sir, all addressed Detailed Answer: Hello once again sir. It is indeed interesting that your investigations reported negative although you reported for a test soon after the blister was popped, but this could also be because you were still less than 12 weeks into the infection. But this is unlikely, and herpes should be ruled out in such cases, but I would like to still keep it as an option sir; as I am worried about the history of contact with the HSV diagnosed woman. As for the presentation; different patients present in a different way sir. I have not seen a patient with exactly the same presentation, but I have seen a few patients with somewhat similar presentations. The discharge points towards a sexually transmitted infection-cause, which is why your doctor will have to concentrate more on a sexually transmitted cause. That is a very good question sir, to be completely sure of ruling out HSV, I would recommend 2 tests to be conducted at 16 weeks and 20 weeks. Once these report a negative result, we can put HSV behind and move forward to other causes sir. I agree with Terri Warren's observation, that the body has never before seen the virus and should start early to build an attack against the foreign substance. But this again differs from individual to individual. Some individuals have a good immune system and can produce sufficiently detectable antibodies at even 2 weeks, whereas, some can take more than 12 weeks. Terri XXXXXXX has spoken about this as well. Yes sir, please go ahead with the test and keep in touch with your infectious doctor. Of course staph can also cause this sir, but your presentation does not typically match that of a staph infection, and most doctors would/should clinically link it with herpes. But leaning towards other causes after a negative HSV IGG test at 12 weeks would also be considered wise. Best of luck sir. And please do keep me informed.

---