[Question #136] Possible syphilis on tongue

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107 months ago
Dear doc,

Two Thursdays ago I went to see a South Korean massuse/csw.  During the session we kissed heavily ( with tongue). 5 days later I found what looked like a papule on the side of my tongue a little more than half way back,it seemed to be an inflamed taste bud. I clipped it off. 2 days later in the same spot I noticed a sore with white edges that looks a bit like a chancre. Is it possible that I could of opened a syphiles chancre. It was open by day 7 after contact. The sore is not painful. I have read some places that the timing is to early and others it can occur? Is it being so early enough to rule out syphilis? Over the last 5 days it has been healing and is getting smaller. During this time I have not kissed my wife with tongue ( or at all) and my daughter I have only given pecks on the lips and have shared drink cups. If I did have syphilis would I have put them at risk? Should I just think of this as a traumatic ulcer
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Edward W. Hook M.D.
107 months ago
Welcome to the Forum.  the chance that this lesion was a chancre, will possible is very, very low.  Syphilis is rare and syphilis of the tongue is very, very rare.  further, as you point out, the lesion appeared rather early for a syphilis lesion,  After more than 30 years in this business however, I have learned to never say never.  My advice, in large part for your own peace of mind, is for you to get a syphilis blood test. If the lesion was syphilis, the blood test would DEFINITELY be positive at this time.  I hope this comment is helpful.  EWH 
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107 months ago
I will get a test. Based on what I said in my previous message did I put my family at risk? Beyond that the sore has almost healed and it's been a week. Is that rather early for a chancre to heal?
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Edward W. Hook M.D.
107 months ago
No, your family will not be at risk.  As I said, syphilis is transmitted only by direct contact.  And yes, a week would be rather fast for a chancre to spontaneously resolve.  EWH
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107 months ago
I just had a rapid syphilis test done (the name of the test is syphilis health check-apparently it is the only fda approved rapid test). It came back negative. This is 6-7 days after the appearance of the sore. Given this a treponal test, is this valid and conclusive?
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Edward W. Hook M.D.
107 months ago
yes, as I said, a negative test at this time is conclusive.  Time for you to relax and move forward without concern EWH
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