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Red bumps on glans with negative WESTERN BLOT TEST.

Resolved Question:

I've just received a negative Western Blot HSV test, but am still concerned.

I had this test done 6 months after a potential exposure. I have 2 small bumps that are slightly red/slightly white on my glans (1-3mm in size each). There are no symptoms of itchiness, burning, tingling, etc.

I am under the impression that the Western Blot HSV test from the university of washington in the US is a very reliable test.


Category: Sexually Transmitted Diseases(STD)Specialist

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Category: Cosmetic and Plastic Surgeon
Dr. Kruti Jobanputra Banodkar is online now

Expert:  Dr. Kruti Jobanputra Banodkar replied 4 Days.

Hello,

Thank you for choosing DoctorSpring.

Yes, Western blot is a very reliable test. It has more than 99% sensitivity and specificity . Especially the modern ones. Western blot tests are typically used to confirm a positive ELISA (antibody test). Have you done an ELISA test ? If so what was the result ? These two bumps are not suggestive or specific for HIV infection.
Do let me know you ELISA test results.

Hope this helps
You can reply as a followup
Please feel free to ask followups
Thank you


Patient replied :

No diabetes
No hypertension
No smoking
No past surgeries

Yes I drink alcohol everyday

I have not had an Elisa test done.
I had a previous western blot 3 years ago with the Same results.

The bumps I was referring to were for hsv not HIV.

What would be the cause of the bumps. They seem to be smaller now and more skin coloured than before. I am not circumcised.

The western blot said I had no exposure to hsv 1 and no exposure to hsv 2.

This test is conclusive according to everything I can find online.


Expert:  Dr. Kruti Jobanputra Banodkar replied 3 Days.

Hello,
Sorry about the confusion. HSV Western blot are also reliable. So most likely you are negative for HSV. Could please upload a couple of picture of the lesion/bump ? I will also get a Dermatologist's opinion on this.

Thank you


Patient replied :

I uploaded 3 pics. 2 of the glans and one of the spot on the foreskin.

The ones of the glans have 2 bumps close to the meatus near the anatomical top to the left.

The one of the foreskin is clearly seen.

Thanks

Also...

I checked this evening and the redness on the glans is all gone and one of the bumps is almost gone. The other is much smaller. That's almost al gone in 24 hours. Weird right?


Expert:  Dr. Kruti Jobanputra Banodkar replied 2 Days.

Hello,

I had a look at all the pictures. The ones on the glans appear to be due to hsv i.e genital herpes and the one on the foreskin appears to be due to bacterial infection. Could you tell me whether all three bumps appeared at once? Was there presence of fluid in any of these lesions? Meanwhile application of neosporin cream over the bumps will help in slowly resolving them.

Awaiting your reply.

Thanks
Dr Kruti


Patient replied :

Hi,
I had a Herpes Western Blot blood test done on January 8, 2014 and it ruled out HSV type 1 and type 2. This is a blood test that is 99.9% accurate. I have had the same sexual partner for the past 5 years.
She is currently pregnant and has never had any known symptoms of HSV.

The 2 bumps on the glans are now both almost non apparent. They showed up on Thursday morning and have almost gone away. That means they went away within 48 hours of even showing up. They did not burst and were not fluid filled. They shrunk and the redness went away.

The bump on the foreskin seems to be decreasing redness and going away as well.

I have included a link about serological testing of HSV from the University of Washington.

http://depts.washington.edu/rspvirus/documents/hsv_western_blot.pdf


http://depts.washington.edu/herpes/php_uploads/publications/Serological%20Testing%20for%20HSV-1%20and%20HSV-2%20Infection.pdf

To answer your question the bump on my foreskin showed up on Monday and the other two bumps showed up on Thursday.


Expert:  Dr. Kruti Jobanputra Banodkar replied 1 Day.

Hello

Thanks for your reply and for your useful inputs.

As I mentioned the bump on the foreskin seems to be due to a bacterial infection.

The bumps on the glans seemed to be due to herpes in the picture but with your history and the results of the test done, they could have been due to yeast infection. One gets just a two dimensional view in the picture, the lesion can't be examined.

Since they have gone away, there is nothing to worry. Clotrimazole cream can be applied on the glans. That will take care of any remaining redness.

Mupirocin cream on the lesion on the foreskin will help to resolve it.

Please let me know if you have any queries.

Take care


Dr. Kruti Jobanputra Banodkar
Category: Cosmetic and Plastic Surgeon
Experience: 
Diploma in Dermatology - Royal College Of Physicians & Surgeons Of Glasgow, UK , 2010
Residency - DNB, Dermatology -  K.J Somaiya Hospital, Mumbai, 2009
Medical School & Internship - MBBS - Dr. D . Y . Patil Medical College, Mumbai, 2004
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