4. A 32-year-old man presents with a week-long history of painful vesicles on the shaft of his penis associated with tender groin adenopathy. Two days ago, the vesicles broke and the pain worsened. The patient had similar lesions a year ago but did not seek medical care. He has had three different female sexual partners over the past two years but has no knowledge of them having any sores or diseases.
Diagnosis: Genital herpes presents with multiple transient, painful vesicles that appear on the penis, vulva, buttocks, perineum, vagina, or cervix. The vesicles break down and become ulcers that develop crusts while healing. Recurrences typically occur 2 to 3 times a year. The duration is shorter and less painful than in primary infections. The lesions often heal completely by 8 to 10 days.
Antiviral therapy is recommended for an initial genital herpes outbreak. Although systemic antiviral drugs can partially control the signs and symptoms of herpes episodes, they do not eradicate the latent virus.
For more information on this case, see “Painful vesicles on penis.”