Red Bumps on the Penis: A Guide to Diagnosis and Treatment - Urology

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Understanding red bumps on the penis can be a complex issue, especially when accompanied by various symptoms and laboratory findings. Based on your timeline and the results of your tests, it appears that you have been through a thorough diagnostic process, which is essential in addressing concerns related to sexually transmitted infections (STIs) and other dermatological conditions.

Initially, you presented with a red bump on the glans penis, which prompted your healthcare provider to consider the possibility of an STI. The tests for syphilis, HSV (Herpes Simplex Virus), and HIV returned negative, which is reassuring. However, the persistence of the bump and the subsequent development of red rashes on your thighs suggest that there may be a different underlying condition at play.

The diagnosis of scabies by the dermatologist is significant. Scabies is caused by an infestation of the skin by the Sarcoptes scabiei mite, leading to intense itching and a rash that can appear as red bumps or blisters. The fact that you have seen improvement with treatment for scabies indicates that this was likely the correct diagnosis for your skin condition. Scabies can be transmitted through close physical contact, including sexual contact, which may explain its presence in your genital area.

Regarding your HSV-2 IgM and IgG test results, the interpretation can be quite nuanced. IgM antibodies typically indicate a recent infection, while IgG antibodies suggest a past infection. The presence of IgM without corresponding IgG can sometimes be misleading. In some cases, IgM tests can yield false positives, particularly if there has been a recent viral infection or other factors influencing the immune response. Your negative HSV-2 IgG results suggest that you may not have a longstanding herpes infection, which aligns with your history of a single sexual partner.

The fluctuation in your HSV-2 IgM levels over time raises questions. The initial positive IgM result could have been due to a transient immune response to another viral infection, such as the Epstein-Barr virus (EBV) or cytomegalovirus (CMV), both of which you tested positive for later. These viruses can sometimes cause cross-reactivity in serological tests, leading to misleading results.

Given your symptoms of recurrent fever and the diagnosis of infectious mononucleosis (often caused by EBV), it is plausible that your immune system has been under stress, which could affect the accuracy of your HSV testing. It is also worth noting that many individuals with HSV-2 may remain asymptomatic, which complicates the clinical picture.

In conclusion, the red bumps on your penis are likely related to the scabies infestation, which has been effectively treated. The HSV-2 IgM positivity may not indicate an active herpes infection, especially in the absence of IgG antibodies. It is essential to continue working closely with your healthcare providers, possibly including both dermatology and infectious disease specialists, to monitor your symptoms and test results. They can provide further clarification and management strategies tailored to your specific situation. If you have ongoing concerns about your sexual health or skin condition, do not hesitate to seek further evaluation and support.