I have a small red bump on the tip of

Patient

Q: I have a small red bump on the tip of my penis. Pain when the bump is touched. It also hurts when my clothes rub against it. It appeared out of nowhere about 2 days ago. I had pain in the spot the night before the bump appeared. My Wife was just tested for all STDs + HIV (she is pregnant) and all returned negative. I was concerned it was syphillis. I was laying outside before the bump appeared, so I'm wondering if it's a bug bite. I also have soreness in my pelvic region; like if a gland was swelling to fight an infection. There is only one bump, this is it. The size of a pinhead.

Symptoms:  Pain with contact, pain with clothes rubbing, pelvic pain in the gland by my left leg
Images: 
I have a small red bump on ...-1
Doctor

A:   Hello,
Thanks for the query to ATD for an opinion,
The pustule on the tip of the penis appears inflamed and filled with pus and there is another one over the left which has probably burned and formed crusts. These are likely to be herpes zoster lesions with typical confluent growth and presentation with fluid filled vesicles which are painful. It is suggested that you should get a swab test done to isolate the virus and ascertain the diagnosis. Also immunohistochemistry for IgM antibodies for HSV 2 may be done to confirm a recent infection. Once diagnosed it would be advisable to opt for antivirals sooner to limit the course of incubation period and shorten the course of disease.
Please visit your physician soon for a local examination and evaluation soon.
I hope i have answered your query in detail,
Wishing you good health,
Regards

Comments / Follow Ups

Patient: Can it be anything else? My wife is pregnant can it effect the baby
Doctor: From the picture it appears to be herpes, however the final diagnosis is always serological. If your wife is not affected and all her tests are negative then it shall not affect the baby in any way.
Regards
Patient: Herpes HV2 but not herpes zoster?
Doctor: It is herpes zoster caused by HSV 2 virus and genitals are the common site of manifestation.
Regards

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