Had a protected sexual incounter with an indian lady(I think) she worked as a prostitution in an Indain hotel when I went there for some business, after that I knew I had low risk since it was protected but india has a larg number of STD patients, so I went home and tested for HIV 4th generation and a PCR test after 8weeks which came back neg also for HepB&C. But the problem is I didnt test for syphilis and Herpes because there was something in my penis!! After the encounter (2.5 weeks) I noticed an ulcer in my penis, it was painless and it was from the skin of my penis, so it was not wet or had any liquid in it(It was like I took a part of my penis skin)  but now! After nearly 10 weeks, I have red dots under left  palm that started with one then became 3 and now im seeing a faint one showing in right hand, I showed it to my gp and he sent me to a dermatologist who said (I dont know, it really looks like secondary syphilis) he ordered a VDRL test and I went to a private lab at the same day and took TPHA which all came back negative. He then said "wait for 3 months and test I cant give you any antibiotics if the tests are negative" I also was taking Augmetin while the ulcer was appearing in my penis for 7 days bec I had a middle ear infection. This is why he said wait for 3 months because he is afraid that the antibiotics had masked the infection which made the tests negative.

I also asked a dermatologist online which said it looks like secondary syphilis and I have to test again, I tested today for only VDRL and It was also neg.

Note: I have a link of the conversation of me and the dermatologist with the picture of the rash can I put it here? Thanks

Welcome to our Forum.  I'll be glad to comment. From what you say your doctor is being thoughtful and cautious.  I'm doubtful that what you have is syphilis but also think that your doctors are being in your best interest by being cautious.  Several comments below:

1.  Context.  Even in India, most commercial sex workers do not have STIs, when they do, syphilis is an uncommon STI, and you used a condom during your encounter.  Even without protection, most sexual exposures to infected partners do not lead to infection.  All of this makes syphilis unlikely. 

2.  Syphilis classically causes painless lesions BUT you used a condom for your encounter and I am assuming that it covered the part of the penis where you saw a lesion.  As it turns out, there are MANY non-STI dermatological problems that can cause penile lesions and the majority of genital lesions and rashes are not syphilis or other STIs.  Further, it sounds like you were taking augmentin at the time your penile lesion developed and this is NOT compatible with syphilis.  A syphilis lesion would not develop while taking augmentin.  Augmentin, taken for 7-10 days would cure syphilis if present. 

3.  Similarly, the second stage of syphilis can cause lesions on the palms and soles of the feet but again, most such lesions are NOT syphilis and most people overlook the occasional lesions/sores/rashes that occur on their hands and feet.  Further, it would be unusual to develop lesions of secondary syphilis after taking penicillin.

4.  IF you had the second stage of syphilis, without a doubt, your syphilis blood tests would be positive.  That your tests are negative also strongly argues against syphilis. 

Putting all of this together, I find it most unlikely that you acquired syphilis from the encounter you describe but I also think that your doctor is being appropriately cautious.  I anticipate that future testing will verify that you did not acquire syphilis.  My suggestions to you is to not worry and to work with your doctor to put this behind you.  EWH

p.s.  We do not look at pictures on this site.  Our experience is that photos are typically of little help and are frequently misleading.  We do not accept them ins efforts to provide the best possible service to our clients.  EWH

I didnt take pencilin only augmentin, so should I wait for more 3 months and get tested again? I also ordered an FTA-ABS test that will be done after 1 weeks from now. 

Also the sores under skin of palms develops one by one, and I only have 3 in my left palm, nothing in the soles of the feet and I think one is developing in my right palm but the doctor said its nothing. 

Could secondary syphilis sores come one after another and not all at once? And shouldnt they be bilateral?

Also nearly 100% of patients will have a positive result in the secondary stage so why should I wait for 90 days to test again.

Last thing, lets assume its syphilis.. in my country they only treat it with oral antibiotics not with pencilin shot!! Could this bring a chance of not eliminating all the bacteria?

These follow-up questions are a bit repetitive so my answers will be brief.

Augmentin is penicillin (amoxicillin actually which , if anything is more active for syphilis than penicillin).

I anticipate that your repeat FTA, or any other syphilis blood test you take, will be negative as your others have been.  When to do it can be debated - your doctor is being conservative and there is nothing the matter with that.  See my comments about blood tests in secondary syphilis above.

Nothing should be made about the time sequence of your lesions.  the clinical presentations of syphilis are highly variable (it is sometimes called "the great imitator").

In my opinion, and I am confident that I know as much about syphilis as anyone in the world, "assuming" this is syphilis would be a mistake.  That said, if taken as prescribed it is clear that oral therapy would be just as effective as shots.  EWH

I'm not sure how many times I need to say it or what words you need to see to understand.  Your risk for syphilis is low and your tests do not support a diagnosis of syphilis.  Because you took antibiotics, your doctor has suggested further testing to be sure.  When you choose to do that is a judgment call.  I am confident that whether you test now or later, your results are not going to change and are not going to show that you acquired syphilis during your low risk extra-marital exposure. 

Our Forum provides up to three responses to clients. This is my third, repetitive response. As a result, this thread will be closed in a few hours without further responses.  Please don't worry- I wouldn't.  EWH