[Question #13168] Clarification Question

1 months ago

Good Evening,

Generally I browse before purchase, but I would like a clarified answer.

Recently engaged in an MSM outercourse encounter. I decided this was the safest course as my own tests were about 6 months old as well as my partners.

Kissing and frottage/apposition, though frankly Im unclear of the difference. The encounter was about 10 days ago. I have had a sore area on my inguinal cleft between my thigh and lower abdomen, adjacent but not directly on my genitals. While I know Im not at risk of any of the fluid born issues, is this possibly a syphilitic issue or more likely an inverse psoriasis issue (historic problem). The sore doesnt have define edges, and appears more raw than anything, no scabs. Think more abrasion appearance than anything with no changes since it showed up Sunday.

Im generally under the impression that "no penetration, no risk" but please clarify if I ran a higher risk than I supposed.

Thanks for all you do!

Edward W. Hook M.D.

1 months ago

Welcome back to the Forum. I'll do my best to provide the clarification you seek. Theoretically, if a partner has an active syphilis lesion which comes into contact with an un-infected partner during kissing or frottage (body sliding) could transmit a lesion disease such as syphilis or herpes. In over 40 years of practice however I have never seen infections transmitted in this way. Thus in the same manner that I will tell you that you are not going to be struck by lightening while reading this reply, I am confident that the outercourse episode you describe did not put you at risk for STI. The lesion you describe is in an unusual location for an STI and sounds like an abrasion or some other process but not an STI. I really would not worry about this encounter. Should you choose to test for syphilis (we strongly recommend against blood tests for herpes, if you wish to have the lesion swabbed for a herpes PCR that is up to you) test results at any time more than 5 days following appearance of the sore area will prove whether it is syphilis or not. I am confident that this is not an STI. EWH---

1 months ago

Dr. Hook,

Thank you for the clarification. Truly your experience is the value here. I searched through the forum and what I largely gathered was that any risk from such events was largely theoretical, but as far as "skin to skin" issues the closest clinical research was on a completely different disease (HSV1) concerning herpes gladiatorum, but a little deeper research really only raised the point that HSV1 (and even HSV2) being classified as std's rather than dermatology concerns is almost dubious.

HSV1 also wasn't my biggest concern obviously. While I'm pretty much relieved, as I have the other questions I suppose then I will ask directly: based on your clinical experience as a leaded in the field do you consided frottage and apposition safe sexual activities?

Edward W. Hook M.D.

1 months ago

You are correct about herpes gladiatorum but remember, in that circumstance, the friction tends to be rather intense during wrestling and abrasions are relatively common.

Both Dr. Handsfield and I consider frottage/apposition/sliding to be safe sexual practices without a need for follow-up testing. EWH

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1 months ago

Dr. Hook,

Thank you again. I think the only reason I considered as a possibility was timing and that while not the genitals, I am a little unclear how close is "too" close. That cleft or crease from thigh to groin is a tricky spot, especially on a transverse plane with the top of the shaft. Not sure what the lines are between genitals and "everywhere else" as it were

Edward W. Hook M.D.

1 months ago

As you know, this will be my final response. I understand that the "genital area" can be open to interpretation but most often in men we're talking about the penis, the scrotum and perhaps a small amount of skin above the base of the penis.

This completes this thread. Please don't worry. EWH

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