Sexually Transmitted Diseases/Shingles or what???

Advertisement


Question
I am 53/female/diabetic/hypertensive/panic attacks . In the year 2000 I had a big red, painful band on my upper back left shoulder that my kids Pediatrician said was shingles.  It healed and since then I have had many, many other outbreaks but always on the left back upper thigh-usually just one place maybe 2 at most the size of a quarter with many cluster pimples in it that had clae stuff and if I mashed them they nearly killed me with pain but scabbed over and eventually subsided.  Since 6 months ago I get the same type (just one or 2) every 6 weeks still on the same back upper left thigh.  I feel needle like pricly sensations prior to outbreak and I am an extremist in regards to stress-I live eat and breathe it-I have major family issues that just cannot be resolved and health issues-so I figure stress does it-then I realized these are chronic and looked up online and wow I got scared--keep seing that HIV and compromised immune systems casue these to be recurrent.  My Dr knows and never comments- and did tests and they are shingles BUT also did tests for Herpes 2 and that was positive also-which back in 1980 I was exposed to herpes when my boyfriend (who played in a band and had a reputaion) and I had sex that made me get inner cervical warts that had to be frozen.  Nevr issues till year 2000-I had chickenpox as an adult back in 1993 and as I thought back to the 1980 Herpes I realized that even back then I broke out on that same thigh n just thought I had been bitten; and my point is THAT WAS BEFORE I HAD CHICKENPOX...now I am upset, tired of pain, etc and wonder what is casuing these and what else could the be besides shingles??? They are just on that one side always and recently a few little ones on my inner labia--I can tell stress does it and I feel tense all the time-a dermatologist says herpes can come over and over but allover and not just one side-so that rules that out-what do u think???

Answer
Hello Ren,
Your stress does sound like it is an important component to these outbreaks. Herpes type 1, herpes type 2, and varicella zoster (chickenpox/shingles), may all have very similar appearances, courses, and resolutions. These three viruses are viruses that reside in the peripheral nervous system, and during recurrences, affect the skin and sensory nerves whereever the outbreak occurs. The only way to differentiate between these three, is with a DNA (NAAT/PCR) lab test that identifies the presence of those specific viruses. Antibody tests from blood samples may INFER, but cannot prove a recent infection.  

The best approach is a correct diagnosis so you know exactly what you have, and then ask for the medication (acyclovir/Zovirax is very inexpensive at places like Walmart; valcyclovir/Valtrex is a twice a day tablet, and costs a bit more, but is very convenient. Either medication is good to help control the outbreaks, but have different dosing regimens based on what you have. You may also benefit from a Shingles/Varicella zoster vaccine if you never had one, and if your outbreaks are not due to varicella.

HIV is associated with this as you mention, but so is your diabetes (under good or awful control?), and all the troubling things in your life and family. So the other and perhaps most important thing to concentrate on is counseling or therapy to reduce and manage your stress.

Hope this helps!  Good luck!
--mark  

Sexually Transmitted Diseases

All Answers


Answers by Expert:


Ask Experts

Volunteer


Mark P. Behar

Expertise

Almost any question or concern about gay men's health issues, sexually transmitted infections, abnormal Pap smears, anal cytology (anal "Pap smears"), etc. There is no such thing as “d/d free” or “clean” (free of infection), so why do so many of us deceive ourselves into thinking that some people are indeed totally free from a potentially infectious disease, like HIV, herpes, hepatitis, syphilis, chlamydia, warts, gonorrhea, etc., just because they say so? Clinical laboratory tests are not perfect, and having a “negative” or “nonreactive” test does not mean that a person is free from infection. Perhaps at the moment the test was taken, the person was uninfected; or, perhaps, the test wasn’t sensitive enough to detect presence of the infection. There is really no way that anyone can determine that they are truly “disease free,” and there are over a hundred of infectious conditions that can be spread without your knowing anything. Rather than trying to “pre-screen” or “serosort” a potential sex-mate with deceptive questions that are impossible to know by today’s technologies, a wiser option may be to consider everyone infected with something, and either use appropriate protective measures (“safer sex”), or accept the responsibility and consequences of possibly “catching” something from someone who’s hotter than expected (pun intended!). There is much research that supports the contention that an HIV positive person reliably taking HIV medications, and having an undetectable viral load, presents a lower risk for transmission of HIV than people who may think or say they are HIV negative, but are not. Food for thought!

Experience

Family Practice PA since 1981; Volunteer Clinician for Brady East STD (BESTD) Clinic, Milwaukee, since 1977; answered STD questions submitted to their web site. Professionally lectured at national and regional Physician Assistant and Nurse Practitioner conferences, and at national gay & lesbian health conferences on topics including HIV/AIDS, herpes, hepatitis, STDs, human papilloma virus (the cause of venereal warts), abnormal Pap smears, gay and lesbian health issues, among others.

Organizations
Co-Founder, Lesbian, Bisexual, & Gay Physician Assistant Caucus of the American Academy of Physician Assistants, Inc.; American Academy of Physician Assistants; Wisconsin Academy of Physician Assistants; National Co-Chair (2012-16), National Association of Black and White Men Together: A Gay, Multiracial Organization for All People (NABWMT)

Publications
Journal of the American Academy of Physician Assistants (JAPA) Q Visions, Quarterly Newsletter of the NABWMT

Education/Credentials
Bachelor's of Arts, 1972 (University of Wisconsin, Milwaukee, WI) Graduate Credits Experimental Psychology, 1972-75 (Tulane University, New Orleans, LA) Physician Assistant, Bachelor's of Science, 1981 (George Washington University, Washington, DC); Masters in Physician Assistant Studies, 2000 (University of Nebraska Medical Center, Omaha, NE)

Awards and Honors
Colposcopy Recognition Award (CRA), the American Association of Colposcopy and Cervical Pathology; Distinguished Fellow, Clinical Preceptor, American Academy of Physician Assistants; Fellow, Wisconsin Academy of Physician Assistants

Past/Present Clients
Brady East STD Clinic, Milwaukee, WI Milwaukee Health Services, Inc. (Martin Luther King Heritage Health Center), Dept. of Family Medicine and Early Intervention Program for HIV Infected Persons

©2016 About.com. All rights reserved.