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Dermadoc
Dermadoc, Board Certified Dermatologist
Category: Dermatology
Satisfied Customers: 2395
Experience:  MBBS, DNB DERMATOLOGY
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Can shingles occur in the rectal area, anus and along the

Customer Question

Can shingles occur in the rectal area, anus and along the crack towards your tailbone. Can shingles occur around the parineum, but absolutely no issues with the vaginal opening or labium? My husband an I have never had any issues whatsoever with STD's, and it would seem odd that this would be genital herpes.
Submitted: 5 years ago.
Category: Dermatology
Expert:  Dermadoc replied 5 years ago.
Dermadoc :

hello

Dermadoc :

hi

Customer:

hellow

Customer:

hello

Dermadoc :

please stop applying triamcinolone ointment

Dermadoc :

thats a steroid cream

Customer:

ok.. that is what my doctor gave me...

Dermadoc :

it aggravated any kind of infection, be it shingles or genital herpes.

Dermadoc :

but shingles can affect only those areas which you have described.

Customer:

it was before the rash actually appeared, when it was just red, irritated and inflamed... so that would make sense.,

Customer:

we will stop using it. but what can I get instead for this delicate area?

Dermadoc :

ok, but please do stop it now.

Customer:

I have to tell you it is a miserable existance

Customer:

okay...

Dermadoc :

please apply neosporin cream instead twice a day.

Dermadoc :

that will heal the lesions better.

Customer:

will the neosporin burn?

Dermadoc :

it may sting a little.

Dermadoc :

but thats the only thing thats available over the counter.

Customer:

okay...

Dermadoc :

bactroban cream or fucidin cream will require a prescription.

Dermadoc :

that may not sting.

Dermadoc :

but i will also recommend that you need to take oral anti viral tablets.

Dermadoc :

its called valacyclovir.

Dermadoc :

this will help in quick resolution of the lesions.

Customer:

so given the area, you feel shingles is most likely. I have suffered shingles before in the arms and abdomen. I have never had any kind of STD.

Dermadoc :

it will require a prescription from your local doctor.

Customer:

I do have some clotrimazole and betamethasone dipropionate cream. What about that one?

Dermadoc :

yes it could be shingles, the characteristic feature of shingles is that it occurs only one side of the body usually.

Dermadoc :

no, please dont apply those two creams, clotrimazole wont help.

Dermadoc :

and betamethasone again is a steroid cream.

Customer:

That is why I was confused. the rectal area is sort of right in the middle... okay... neither cream.. got it.

Customer:

Is it true that once you suffer shingles in a given area, it will never affect the same area twice?

Dermadoc :

no thats not true.

Dermadoc :

it can occur in the same area again.

Customer:

ok

Customer:

one last thing. If they take a culture, can the tell the different between HSV2 and Zoster?

Customer:

difference I mean.

Dermadoc :

viral cultures are very difficult to achieve.

Dermadoc :

the method that is carried out, is called the tzanck smear.

Customer:

so as long as I don't seem to have a vaginal canal or opening outbreak, you think shingles the most likely? I wish we could know for sure to protect my husband as he has never had any issues and we have been together for 4 years now. Would it really be likely for us to both be unaffected for 4 years and then end up with genital herpes? There is no question that neither of us has strayed. Could I have carried it for that long from an indiscretion over 4 years ago before I met him? Also, you should know I am in a very high stress lifestyle. I have had shingles on my arms and chest, abdomen several times in the last four years.

Customer:

Did you leave?

Dermadoc :

no i am still there

Dermadoc :

i am reading your query.

Customer:

ok

Dermadoc :

genital herpes can occur in 2 areas.

Dermadoc :

one:- vaginal opening

Dermadoc :

second:- anal opening

Dermadoc :

if you had an anal intercourse, it can occur in that area

Dermadoc :

and if you had only vaginal intercourse it will affect the vaginal opening.

Customer:

neither opening had lesions or blisters.... on the checks inside the buttocks and rectal area, up towards the tailbone. Annus was the one place that did not have any sores or pain.

Dermadoc :

ok.

Dermadoc :

then the shingles seems more likely.

Dermadoc :

its a sexually transmitted disease.

Customer:

okay... I will be calling my dermatologist tomorrow. is that the best type of doctor to diagnose and treat?

Dermadoc :

i mean genital herpes is a sexually transmitted disease.

Dermadoc :

yes a dermatologist is the best person to treat this.

Dermadoc :

usually the appearance is different in herpes zoster and genital herpes.

Dermadoc :

in genital herpes, the blisters filled with clear fluid which are in clusters.

Customer:

you have been very helpful for what is a very embarrasing condition. Thank you. I will call in the morning.

Dermadoc :

whereas the herpes zoster has fluid filled blisters again in clusters but on a reddened base.

Dermadoc and other Dermatology Specialists are ready to help you
Expert:  Dermadoc replied 5 years ago.
modern tests, such as the direct immunofluorescence with fluorescein-tagged antibody (DFA) or PCR (if available), are preferred over the Tzanck smear. These tests have far greater sensitivity and specificity than the Tzanck smear and allow differentiation between herpes simplex virus (HSV) i. e genital herpes virus and VZV i.e the herpes zoster infections.
please ask your dermatologist for them but usually we differentiate between the two by clinical examination. they present differently.
you are always welcome if you have any queries.
regards