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is it shingles or herpes?
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cj4646 posted:
Hi all, Just found this site and have a dr. app. friday but in the mean time I am stressed. I am 46 years and married for 23. Not worried at all about infidelity. I had what looked and felt like a spider bite on my left butt cheek about 10 years ago. Dr. scraped it, tested and said it was shingles and gave me medicine. Since then it has appeared maybe 3-4 times but maybe larger(may be in my head). About 6 weeks ago I thought I had a yeast infection, which I have not had since hysterectomy in 95... I really thought I had vaginal shingles but I think it's impossible. I am really worried because when my "shingles" on butt flair up I don't take anything and it crusts up and goes away. It's been at least 6 weeks... thought it was gone last week and now another canker type bump. Nowhere can I find anything that matches my symptoms. Dr. that diagnosed me is long gone and dreading explaining all this to newer dr. Anyone know what's going on? thanks in advance.
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J_Harrison_Hohner responded:
Dear cj:Welcome! It can be very difficult to determine which type of herpes is responsible for outbreaks on the buttocks. Certainly if one has ever had genital herpes simplex virus (HSV) on the labia/clitoris/vagina the HSV can go dormant into the nerve root. Then it will either reappear in exactly the same spot (very common) or travel along the nerve dermatome to the cheek of the buttock. The women often wonders if she somehow spread the virus unknowingly to her buttock. Yet the origin of the buttocks lesion was along the nerve path from another site.

Herpes zoster ('shingles") can also appear in many body sites (most commonly the thorax). Zoster also hides in the nerve pathways. It gets there when a person has had chicken pox then goes dormant. Thus the lesion on your buttock could be either one of those viruses--and in fact they are both treated with anti-viral medications such as acyclovir. The only way to know for sure is to do viral cultures, or tests for viral DNA, when the lesions are fresh and shedding virus.

In terms of the vaginal symptoms, Zoster is not often found on the genitals. There were only 15 citations on this at the National Library of Medicine site, most were very old. Here was the best of the lot:

Obstet Gynecol. 2002 Apr;99(4):625-8. Postherpetic neuralgia after shingles: an under-recognized cause of chronic vulvar pain.

Oaklander AL, Rissmiller JG.

Neuropathic Pain Study Group, Departments of Anesthesiology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA.

BACKGROUND: Vulvar shingles, an uncommon presentation of a common disease, probably affects 1.5 million American women during their lifetime and leaves about 150,000 with postherpetic neuralgia, a chronic neuropathic pain syndrome. Prompt diagnosis and treatment can minimize pain severity and duration. CASES: The case of an 88-year-old woman with sacral shingles is described. Complications led to her demise. A 35-year-old with a 6-year history of disabling vulvar pain and many diagnostic procedures was ultimately diagnosed with postherpetic neuralgia. CONCLUSION: Shingles needs to be included in the differential diagnosis of vulvar rashes because it is a modifiable risk factor for chronic vulvar pain. The possibility of postherpetic neuralgia must be considered in women with unexplained vulvar dysesthesia.

Bottom line, my suspicion is for genital HSV over Zoster for the vaginal symptoms--and perhaps the buttocks. One can carry HSV for YEARS and never have had a severe outbreak. Many times it is assumed to be " yeast".

PLEASE, PLEASE get in to see a GYN, especially when you have symptoms, so you can get a more "for sure" diagnosis. If it is a virus you can receive medication to shorten an outbreak and stop viral shedding.

One who has been there, Jane

PS Check this link for an excellent Herpes Zoster overview targeted at health care providers:

emedicine.medscape.com/article/788310-overview
 
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jss3677 responded:
had same the symptoms...same area. dx with shingles. 2 months later still there. very itchy. i was on a beach for a week and it turns out i got a parasite possibly from dogs also being on the beach. i was sitting in small inlet puddles with my little infant nephew. being treated now with Albenza. i suffered 3 months before i got a proper dx today. i.e. look up hook worm
 
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Jane Harrison Hohner, RN, RNP replied to jss3677's response:
Dear jss: Thank your SO much for taking the time to write about your missed-diagnosis of hookworm. Generally hookworm tends to prefer warmer areas (eg southeastern US as opposed to Oregon coast), so unless someone has been traveling to the third world I would not think about hookworm.

For anyone who finds this discussion in the future, here is a link to an excellent discussion about hookworm and its symptoms:

http://www.cdc.gov/parasites/hookworm/gen_info/faqs.htm l

In Appreciation,
Jane
 
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Moofer633 responded:
I have similar experiences with "shingles on the butt". I've had this problem flair up about 3-5 times a year and appears on either cheek. As you know, it's quite painful. The only thing I do is keep the area dry and apply witch hazel. It is what it is. I don't worry about it, but I am curious as to why I get this so often,
 
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grubpubert responded:
It sounds like shingles to me.but this chicken pox virus really morphs. Suddenly in late 2004 I got ocular herpes, a horrible outbreak on both eyes. This migrates to outbreaks in feet, hands and fingers, to calves of legs, and back to eye lids and eyeballs. I became obsessive, since I am a grandmother, about hand washing and never sharing food utensils or glasses or cans with granddaughters. When the herpes was in it outbreak stage I stay isolated from the..... Anyway this herpes eventually morphed into having the genital kind, and shortly thereafter a horrible liberal of shingles on my butt which has totally immobilized me and has caused the most pain I have ever had as 34 boils emerged from those tiny red patches of pustules and worked their way up to my tailbone, where they broke through my skin and left my endodermis and coccyx exposed. There has only been acctclovir and a hundred homeopathic things I have tried, and I wake up screaming in pain several nights a week. I had to rent a hospital bed and I have to sit on 2 rubber donuts at all times. My ONLY relief is the prescription lidoderm patches prescribed for fibromyalgia. these have truly saved me, cut in half and taped over the spiral shaped remains of the outbreak, which are HARD, like cartilage, and the boils that keep growing from the "mother ship. " I am very small & extremely thin, 59 years old, and in my 16t week of this agony.


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