Is this herpes despite negative test?

Patient

Q: I have bumps/rash in between my genitals and scrotum, but got a negative test for genital herpes. Should i be worried?
EDIT:
In addition, my lymph node in the genital area has swelled. The reason why I am worried is because I went to a strip club 3 weeks ago and even though there was no intercourse. Our genitals were close to each other and I had a condom on. The test was done 20 days after the potential exposure

Images: 
Is this herpes despite nega...-1
Doctor

A:   Thank you for the question to Ask The Doctor.

Since the rash is not on the penis itself, I do not believe that it is related to an allergic reaction to the condom that you were wearing. An allergy to latex is a common reason that people get such a rash.

I am looking at the spots and they seems to be vesicles that are fluid filled but not blood filled. These can occur in allergic reactions, trauma and STDs.

I believe that these are localised lesions and not spread over a large area of the groin. I believe that injury to the area at the strip club may have caused this. If you did get a lap dance, you could also have gotten this injury. This is one possibility but not the most likely as the trauma would disappear within 7 days at the most.

I would recommend that you start with an anti-allergic like Cetirizine 10 mg tablets once a day for 3 to 5 days. This should reduce the itching and the rash. If the rash begins to grow in size or the itching increases, you probably have an STD or a fungal infection.

You will need to rule out one or the other by seeing a Doctor and getting a STD panel test done or scraping of the lesion to check for fungal growth.

Do follow up to add in more info. I will answer your concerns in detail.

Hope you have a speedy recovery

Comments / Follow Ups

Patient: Hi Doctor,

Thank you for you prompt reply. I want to update you where I stand. They were able to take a closer look at it and they said that it is most likely Shingles.

My lesions and bumps are not on my penis and the only reason why there isn't a definite answer is because I have that swollen lymph node in my groin.

I found out they didn't administer a herpes test during my original screening so I just took a herpes test and did a test culture on the skin. In addition, they prescribed me to Valacyclovir I hope it all works out. What are your thoughts on it?
Doctor: Thank you for the follow-up.

Shingles is a good catch. VIrus that causes chicken pox lies dormant in the body and later affects one half of the body causing the symptoms.

And the vesicles are similar to what you have. You are also not presenting in the exact way a patient with shingles present.

Did you get the Tzank smear? If yes, then you were diagnosed well.
Valacyclovir is the right treatment.

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