Herpes Symptoms: Blood Tests and Skin Biopsy Insights

Herpes issue, there is a small, unusual red swelling about 0.5 centimeters on the upper right side of the lip?

Hello, doctor! I apologize for bothering you again regarding #175699.
I have a few questions:
1.
Is it correct that the antiviral medication only treats the current symptoms and does not affect the blood test results? If it does affect the results, how long should I wait before getting a blood test for more accurate results?
2.
It was mentioned that blood tests are just a reference and symptoms can vary from person to person.
If I really want to confirm whether I have the condition, should I only have a skin biopsy done when symptoms are present? Would you recommend this? Where can I go for this? I have never undergone a skin biopsy; does it require surgery?
3.
I understand there will be uncertainties, but if I want a scientific approach to avoid recalling past mistakes when similar symptoms appear after a year, should I follow these steps? If none of these steps yield results, should I consider checking for other skin diseases?
3-1.
Current situation: Since November 11, 2021, I have felt something unusual, and as of November 18, 2021, the redness persists, along with a slight odd sensation.
There are no blisters or scabs, just persistent redness, and sometimes a mild tight feeling in the area.
3-2.
Process: Step 1.
Instead of returning to the previous hospital, I will visit a different one and ask the doctor what it might be.
Regardless of the outcome, I will communicate with the doctor about the possibility of a skin biopsy and inquire if a blood test can be arranged at the same time.
(If the skin test is negative, it can provide more accurate confirmation that this area is not herpes.) Step 2.
I will get tested for herpes types 1 and 2 IgG and IgM, as I read online that IgM may not be detectable after four weeks, so I will check for IgG to see if I have had it before.
If IgM is present, I will check that as well.
Based on my current situation, when would you recommend I get the blood test? (If negative, it can serve as a reference that I am not currently infected with herpes.)
Step 3.
If the first two steps are negative, I will feel relieved.
If they are positive, this step will not be necessary.
If the blood test is negative, I am concerned that since it has been seven days, the viral load may have decreased.
If similar symptoms occur again, I will promptly seek medical attention for a skin biopsy.
However, sometimes the symptoms are too subtle to assess easily! Should I follow these three steps, or is there truly no way to achieve a report with over 99% accuracy for this condition? Is there anything else I might not know? I would appreciate your guidance.

Niming, 20~29 year old female. Ask Date: 2021/11/18

Dr. Wu Yuxin reply Dermatology

Your issue is not easy to address online; I recommend visiting a dermatologist or an infectious disease specialist for evaluation.

Reply Date: 2021/11/18

More Info

Understanding herpes symptoms and the diagnostic process can be quite complex, especially when considering blood tests and skin biopsies. Let’s break down your questions and concerns systematically.

1. Impact of Medication on Blood Tests: You are correct in your understanding that antiviral medications used to treat herpes, such as acyclovir or valacyclovir, primarily target the virus and alleviate symptoms. These medications do not typically affect the results of blood tests for herpes. However, if you are considering a blood test to check for herpes antibodies (IgG and IgM), it is generally recommended to wait at least 4-6 weeks after the onset of symptoms or after potential exposure to ensure accurate results. This waiting period allows your body enough time to produce detectable levels of antibodies.

2. Skin Biopsy and Blood Tests: If you are experiencing symptoms consistent with herpes, such as redness or discomfort in a specific area, a skin biopsy can be a useful diagnostic tool. This procedure does not necessarily require surgery; it can often be performed in a dermatologist's office under local anesthesia. During the biopsy, a small sample of skin is taken from the affected area and examined for the presence of the herpes virus. If you are asymptomatic, blood tests for herpes antibodies (IgG and IgM) can provide information about past or current infections. It is advisable to discuss your symptoms and the possibility of a biopsy with a dermatologist, who can guide you through the process.

3. Diagnostic Steps: Your proposed steps for diagnosis are logical and systematic. Here’s a refined approach:
- Step 1: Seek a consultation with a new dermatologist. Discuss your symptoms in detail and express your concerns about herpes. Ask about the possibility of a skin biopsy if symptoms persist.

- Step 2: Request blood tests for herpes simplex virus (HSV) types 1 and 2, specifically IgG and IgM antibodies. This can help determine if you have had a past infection or a recent one. If you are currently symptomatic, it may be beneficial to have the blood test done after a few days to a week, allowing for a more accurate assessment.

- Step 3: If the blood tests return negative and symptoms persist, you can consider further evaluations for other skin conditions. If the tests are positive, follow up with your healthcare provider for appropriate management and treatment options.

4. Uncertainty and Follow-Up: It is important to acknowledge that while diagnostic tests can provide valuable information, they are not infallible. The accuracy of tests can vary based on timing, the individual's immune response, and the specific test used. If you experience new or worsening symptoms, it is crucial to seek medical attention promptly.
In conclusion, while there is no single test that guarantees a 99% accuracy for diagnosing herpes, a combination of clinical evaluation, blood tests, and possibly a skin biopsy can provide a comprehensive understanding of your condition. Open communication with your healthcare provider is essential to navigate this process effectively. If you have further questions or concerns, do not hesitate to reach out for more personalized advice.

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