Sexually Transmitted Diseases/Old scar bumps or herpes

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Second bump
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QUESTION: Hey mark I just have one more question in regards to a bump kinda under the penis head in which you see from the pics; prior to this all the bumps or healed skin were torn before due lack of lubricant-ion but it never itched or caused any pain whatever I was just worry it just looked weird and needed some verification; From the last time I sent you a question I got a full STD test in just waiting on the result and have to wait due to my PCP is on vacation. Again I thank you for your time.

ANSWER: Hello Again, Mark,
Lots of little cosmetic imperfections occur on the skin, including on the penis.  I cannot see the bumps you are referring to in the photos.  Skin bumps usually occur in the skin, and can be seen and felt as elevations off the background terrain. Sometimes these variations occur in the deeper structures of the connective tissue, and show through by "poking" through and becoming somewhat visible. It does not look like HPV/warts, or any residual effects of previous herpes infections (no scarring usually develops following a herpes outbreak, if you've had them).

The only thing I am concerned about is what you say you had run: "a full STD test" as there is no such thing.  Certain doctors, clinics, or labs may identify a certain number of tests as a common STD panel, to include blood for syphilis, HIV, and hepatitis B, and perhaps additional swab tests (usually DNA based tests called NAAT) for gonorrhea and chlamydia of the urine, throat, anus, and/or cervix, and sometimes a trichomonas urine test. Notice, that herpes testing was omitted, because it may include an assortment of nonspecific blood antibody tests, or a very specific viral DNA swab from an actual lesion, but an active blister, ulcer, or sore must be evident. As such a lesion is not usually present, the test is not used. Note, there are no good lab tests for HPV/warts, as this is usually diagnosed clinically, without a lab test.

Good luck!
--mark



---------- FOLLOW-UP ----------

QUESTION: Thanks mark what I meant to say is I got blood& urine tested for the usual STD + herpes I was negative for HIV just waiting on the other results. Again thanks for taking the time to help me out I'll update you w. The results

Answer
Hi Again, Mark,
As I mentioned before, blood tests for herpes are difficult to interpret, and it's tough to attribute a meaning for the test results. You may have had one or more of these:
herpes (HSV) 1 IgG
herpes (HSV) 1 IgM
herpes (HSV) 2 IgG
herpes (HSV) 2 IgM
herpes (HSV) 1 or 2 IgG
herpes (HSV) 1 or 2 IgM
herpes (HSV) 1 NAAT
herpes (HSV) 2 NAAT
herpes (HSV) 1 or 2 NAAT
among others!

Let me know which of the tests were done with their results and perhaps I can help you interpret.

mark  

Sexually Transmitted Diseases

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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

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