[Question #13135] Syphillis and oral

2 months ago

Hi doctors,

I had an oral encounter with a female CSW about 2 weeks ago. I have what feels like a raised bump/ ingrown hair on the shaft of my penis. While it doesn’t look like pictures of chancres, I read it can appear as an ingrown hair (according to ChatGPT). I know ChatGPT can often be wrong so I want to confirm with you. If this could potentially be syphillis, would a test be positive at this time?

2 months ago

And to add- I said shaft but closer to the tip and on the foreskin. No change in appearance in 4 days and color looks the same as the rest.

Edward W. Hook M.D.

2 months ago

Welcome to the Forum and thanks for your questions. I’ll be happy to comment but to determine what is causing the lesion you are describing you need to be examined by an experienced clinician and be tested. Statistically it is unlikely that the lesion syphilis and what you describe does not sound like it. Folliculitis in the area you describe is common. My advice is to get tested. If it is syphilis the test will be positive. EWH---

2 months ago

Thanks, doctor. I went to the dermatologist and saw a PA. She said it was a small cyst and was unconcerned with is being syphilis. She recommended no action.

My question:

1) should I test at this time? If I have a cyst, would a test be positive or is it a waste to test 2 weeks after the act?

2) I also took an HIV RNA test and it was negative at 11 days. Do I need further testing? I am only concerned because I have a chest rash that looks like multiple pimples (never have had this before) but I’ve also been on the road for 2 weeks and sweating in heavy clothes.

2 months ago

I should mention there are no other symptoms. Also, can the rash be isolated to the chest if it’s HIV?

Edward W. Hook M.D.

2 months ago

1. Testing is a personal decision. I’ve told you that what you described did not sound like syphilis and now you’ve been examined by a professional who has provided an alternate explanation. If you are still nervous, a Syphilis blood test is easy to do, but I do not think it is necessary.

2. HIVRNAPCR tests are conclusive.Any time more than 11 days after an exposure. There are no proven cases of HIV acquired from receipt of oral sex. I would not be concerned about HIV.

You have one follow up remaining. EWH

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2 months ago

Thanks doc. Clear on all that. Last question- if I got oral sex from two CSWs for several hours, would you advise PEP?

Edward W. Hook M.D.

2 months ago

No one has ever been proven to acquire HIV from receipt of oral sex. You will not be the first. You do not need PEP.

This completes this thread. Take care. EWH

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