[Question #11011] Syphilis Concern - Hand Spots
17 months ago
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Hello Doctor,
I'm coming back to this portal to ask for some guidance since about a month ago I gave protected oral sex to two transgenders and they also ejaculated on my chest.
2 weeks after exposure , I took 1.5 g of Azithromycin and Doxycycline 200 mg per day for 14 days just for peace of mind. 3 weeks post exposure i started noticing a very tiny red dot on my left hand and now i have two very small dots that initially look red and now they look more like brownish (On the link below I'm sharing a picture showing the spots I'm concerned about on my hand ).
Other than the hand dots i haven't had any other symptoms, so I'm wondering how likely is this rash on my hand related to syphilis? even i had syphilis i should see a hand rash at 3 or 4 weeks post exposure right? isn't too early?
Can you still get a hand rash related to syphilis after taking doxycycline for 14 days on incubating or early syphilis?
I'm on week 4 now post exposure so i took the RPR test earlier today, will have the results in two days but wanted to know how likely is that this would be syphilis related instead of something like herpes which i already have.
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H. Hunter Handsfield, MD
17 months ago
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Welcome back, but I'm sorry you found it necessary -- especially since you provide the answer yourself, without knowing it. There is no possibility you have syphilis or that it explains the "dots" on your hands or any other symptom you have now or might develop. Doxycycline in the amount you took is 100% curative of syphilis, and in preventing it from developing in someone who has been exposed. It is so effective that the exact regimen you took -- 200 mg daily for 2 weeks -- is now the treatment of choice for syphilils under a year in duration in those many places around the world where benzathine (long-acting) penicillin is in short supply. Because it is so effective, there was no point in even being tested for syphilis. Your test today will be negative, and you should not have any further syphilis tests.
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In addition to all that, there was no chance of syphilis from the exposure you described.
We do not examine clinical photos on this forum and do not permit their display. It comes too close to practicing medicine from a distance, which we cannot do. I have deleted the link from your question.
Also please note that duplicate accounts are not permitted. In the event of future questions on the forum, please choose one of your sign-ins and don't use the last one or any others. Thanks.
HHH, MD
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