I got a herpes rash on my thigh. Will it spread to my genitals?

Question

Hello doctor,

I am a young female who recently developed a rash on my left thigh. It was very painful and looked very similar to a shingles rash. So I went to urgent care to be examined, and they performed a culture swab.

My relationship status is that I live now with my ex-boyfriend, and he was the only male I was with for the past three years. We had a make-up relationship session last night, and this morning, the urgent care informed me that the culture swab came back positive for herpes simplex 2.

I am quite confused as to why there is only one lesion present, and it is nowhere near my genital area.

I have not had any abnormalities in my genital area, nor any difference in urinary tract issues or anal abnormalities. So, can you give insights on the following:

Should I be taking regular precautions as if I had genital herpes?
Should my ex-boyfriend go and get tested?
Also, is there a chance that the swab's results were incorrect?
Can I expect to eventually have genital symptoms?

I am so lost and scared, and the urgent care facility is not helping with my concerns.

Please help me.

Answer 1

Hello,

Welcome to icliniq.com.

I understand your concern.

Genital herpes normally presents with lesions or cold sores, as you mentioned, and the rash can be a very atypical presentation, which is also rare. It is mostly the cold sores and the mucosal lesions, which ultimately crust and heal on their own.

The issue is that a lot of times, herpes can be acquired, and the symptoms will not be manifested for a long time in people with good immunity. Since you have been with your partner for three years, without any other sexual exposure, it is better that he gets tested and rules out herpes, too.

As I said, it can be asymptomatic, and it is better to know the status. Generally, herpes tests are highly sensitive, and 95 % of the time they are right. But I will still suggest you get yourself re-evaluated for herpes and other STDs (sexually transmitted diseases) like chlamydia.

If a positive result comes up once again, with appropriate treatment of Acyclovir, the outbreaks can be reduced to a large extent.

I hope this helps.

Thank you.