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please clarify dr.bob!!
Nov 1, 2002

hello there dr.bob, you are such a cool dude, i hope everything is going ok for you. well i just want to clarify something....i've heard from my regular doc that shorlty after ars, even if the person didn't have major symptoms, that their lymph glands, especially the neck would become swollen and noticeable. Is this true? I don't have any swollen lymph glands I think, but I do have seborrheic dermatitis on my face which is pretty bad. And I NEVER had this before!!

I read an article about a seropositive patient being evaluated for the first time and that person was fine, except for seborrheic dermatitis on the face. Can dermatitis present itself only a month after a sexual exposure? Or is stress causing this? Should I get tested?

I know this is a fatique forum, for those with HIV, but I really feel that I may be infected with this symptom. I just want an honest opinion from the best expert on this site. You are truly a godsend and I want to contribute to your Robert Frascino HIV/AIDS fund. Hopefully someday I can meet you in person to thank you. Take care, Eric

Response from Dr. Frascino

Hello Eric,

If you've had a significant risk, such as unprotected anal or vaginal sex, then you should get tested 3 months after the possible exposure. Symptoms are notoriously unreliable for diagnosing HIV. Some folks have essentially no symptoms while others can get quite ill with an acute seroconversion reaction.

Seborrheic dermatitis is an incredibly common skin disorder. I certainly wouldn't jump to conclusions that this is related to an HIV exposure 1 month ago. In fact, the odds are extremely high that it is NOT related to HIV. Can seborrheic dermatitis be seen in HIV-positive folks? Yes, it can, but usually not after only 1 month. Can stress be making your rash worse? Yes, it can.

Lymph node swelling is also very nonspecific and varies greatly from patient to patient. This is not a reliable indicator of HIV infection!

Bottom line: Your symptoms are not at all concerning to me; however, if you've had a significant risk exposure, go ahead and get tested at the 3-month period. You'll be WOO-HOOing shortly thereafter. Remember to practice safer sex (condoms!) in the future to avoid all the stress and worry. Sex is supposed to be fun, not anxiety provoking!

Thanks for your contribution! Tax-deductible donations can be sent to:

The Robert James Frascino AIDS Foundation 779 Altos Oaks Drive, Suite 200 Los Altos, CA 94024

Stay well. Happy Halloween!

Dr. Bob


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