I know this is likely anxiety bringing me here like many other people but i need confidential advice.

Around 7 weeks ago i received unprotected oral from a man i wont go into my situation but this has left me feeling awful guilt.

At about 2 weeks mark i did testing which was negative this also included a syphilis urine test which i know would have been done too early but it gave a little peace of mind all others where negative and i was happy.

From then on i have been checked around the genitals for chancre daily in the shower and bath but not seen anything.

Now the other day i have a small smooth rash on the back of my hand(not palm) it stung for the first day but today it is still but doesnt itch or have pain unless under water it is smooth.

It is making me think i have secondary syphilis.  I know with oral the odds are with me i likely dont have it but is it possible to have this especially with no chancre ever forming? Would this be a symptom without any other symptoms? Perhaps its just stress? I am really worried thanks

You had a very safe sexual exposure:  all STIs are rare after receiving oral sex and for some there is no risk at all. For example, in the 40+ years of the worldwide HIV/AIDS epidemic, there has never been a proved case of HIV transmitted oral to penis. As for syphilis, = it's not quite that rare -- a modest proportion of syphilis cases in men having sex with men are attributable to oil sex. However, there is little or no chance your current rash is due to syphilis, and I'm glad to see you already understand it's very unlikely you have it. Not having a genital lesion (i.e. a chancre, the initial sore caused by syphilis) is reassuring. Although some cases of primary syphilis are symptomless, that's generally because the chancre is in a hidden location, e.g. in anal area, inside the rectum or vagina, etc. But obviously you would not have missed a sore on your penis, which the only site it could appear.

Your blood test at 2 weeks was meaningless -- too early to be positive. However, a repeat syphilis blood test at this time will be conclusive. You can expect a negative result. At that time, if your rash is continuing, see your doctor about it. In the meantime, you can cool your jets about syphilis:  there is no realistic possibility of it.

I hope these comments are helpful. Let me know if anything isn't clear.

HHH, MD

So just so i know what to look out for the first symptom should be the chancre which i have not found and trust me i have been looking!

Also for the rash is there anything distinctive to a syphilis rash to look for? there is much conflicting information online

My exposure was MSM and i know odds are slightly higher there.  I spoke to local sexual health who believes my risk is negligible(there are 369 cases of syphilis in our country with a population of 7 million) she didnt believe the rash was it so if i wanted to get peace of mind testing she recommended waiting an additional two weeks as nhs recommendation is 9 weeks and she didnt want me thinking i had a false negative

Im just trying to get all my minds questions answered thank you.

So from your opinion this rash does not sound like syphilis?i do think it is starting to clear up and it is changing texture feeling rougher.

So if i can get this out there,

Chances of syphilis from my exposure are extremely low not 0 but low percentage.  If have this look for chancre without presence then should be fine(i say should as never say never) rash without chance in my scenario explained is as close to 0 chance of syphilis as could get 

That completes the two follow up comments and replies include each question, and so end this I hope the discussion has been helpful. Best wishes and stay safe.