Sexually Transmitted Diseases/Red marks

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QUESTION: I have had red dry marks on my Gland for some time now back and forth, I feel it is getting worse. I went to my provider the other day and she is sending pictures to a Dermi, but she pointed out small bumps that I have't noticed before, again I have noticed the red dryish skin. She doesn't seem very well informed and automatically said maybe herpes. I have not been sexually active in a few years because of this disorder, it has been treated as fungal in the past and still comes back. I am very scared since she used the word herpes and now I have to wait for the dermi to get back to her, another opinion would be greatly appreciated.

ANSWER: Hello CW,
The images absolutely do NOT LOOK LIKE herpes to me. Herpes is a recurrent skin infection caused by a virus that  travels along a peripheral nerve from the nerve root near the spine to periodically infect the skin.  It comes, and then goes into remission over the course of 1-3 weeks, and may recur again many months, years, or decades later. Check out the <http://www.cdc.gov/std/herpes/default.htm>  website for more information about herpes.

It is often far easier to tell what you DON'T have than what you do have!  It does have certain characteristics of a skin fungus, and for that reason, I would try you on something like terbinefine (Lamisil) anti-fungal cream, available without a prescription.

It could also be a skin condition, unrelated to sex at all. You didn't mention if you have any chronic skin conditions, or whether you had anything else, or are taking any medications for any reason.  

Good luck!
--mark


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QUESTION: Thank you for your time, if it was a fungus would there be any characteristics of herpes? Along the ring of there head there are little bumps I haven't noticed in the past. They do not a pear to be fluid filled though. I do not have any skin conditions that I know of. I don't know if you can see the bumps at the base of the head in the picture. I couldn't get it to focus any closer. Thank you.

ANSWER: Hi Again, CW,
No photo in most current post, so I cannot comment about the bumps that you see. Herpes is a viral infection. Fungal infections are caused by fungi. Two separate conditions, and they both look and progress/regress very differently. Try to upload photo, and I can look at it!

Good luck!
--mark

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QUESTION: These are the best pictures I can get of the bumps, they are in a row along the edge of the head. I have no lt had any pain like I read about with herpes, nor fluid coming from them. But there is slight discomfort and a lot of dryness from the red areas.

Answer
Hi Again, CW,
These bumps look like the perfectly normal variation in skin sometimes known as pearly penile papules. Usually, they are much more prominent than what you have.  Nothing to worry about, and no it is NOT herpes.

Good luck!
--mark  

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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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