[Question #3964] Syphilis concern

31 months ago
Hi. About 4 to 5 weeks ago I had 2 encounters with 2 different female escorts while on vacation in New Zealand. Each time there was kissing, protected oral on me, handjobs and me fingering her. There was no intercourse.  About a week or 2 ago, I noticed a small lesion in the inside of my wrist and I have concerns.
I understand that syphilis sores often show in the genital or mouth region (being the site of exposure) but i have seen comments that they can appear anywhere on the body. Could this be a syphilis sore?
Also, my wife told me yesterday that she had an ulcer on her soft palate.  We have not had sexual relations since my trip to New Zealand and she has not had any other partners.  I have read that syphilis is more often transmitted sexually but can be transmitted in other ways.  Is there is a risk that her ulcer is related to syphilis?
Is there a risk of any other diseases that I should be tested for?
Thanks for your help. 
Edward W. Hook M.D.
Edward W. Hook M.D.
31 months ago
Welcome to the Forum.  Although syphilis can occur at any site of sexual exposure, the chances that either of the lesions you have described are miniscule and simply not a realistic concern.  While you do not describe the lesion on your wrist, if it resolved without therapy over a period of less than a week it was not syphilis.  With respect you your wife's palate sore, both the timing of the appearance of the lesion and the fact that there is no history of potential lesion contact with her palate. 

I see not reason for concern and no need for testing of any sort.  If you feel you must be tested for syphilis however, I can assure you that if the lesion that occurred on your wrist was syphilis, your syphilis blood test at this time would now be positive.

My honest opinion however is that you really have no reason for concern related to the lesions you describe in relationship to your vacation-related encounters.  I hope that my comments will help you to move aside.  EWH
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31 months ago
Thank you Dr Hook. The sore appeared Monday or Tuesday before last. It was a 1-2mm bump with a divot in the middle. I picked at it last Sunday and it bled but has been scabbed over since Tuesday and is still there - now a 2mm scan with red skin around it with a total size of 5mm.  So it has lasted more than a week. Does this change anything?
Edward W. Hook M.D.
Edward W. Hook M.D.
31 months ago
No, no change in my assessment.  One change in my advice however.  Try to avoid picking at the lesion as this will change its appearance and only confusing assessment.  EWH
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30 months ago
Thank you Dr Hook.  I ended up getting tested and the RPR came back as non reactive.  However, two days ago my infant daughter had a fever and whole body rash.  Given the lesion was on my wrist and she could have come in contact, is there any chance that the test result could be a false positive and this rash related to syphilis?  The fever cleared in 24 hours and the rash is almost gone after 48 hours. I have heard that RPR can have false negatives.
Edward W. Hook M.D.
Edward W. Hook M.D.
30 months ago
You need to stop attributing every event that you see in your family to syphilis.  Syphilis almost never causes fever and the rash of syphilis does not resolve in 48 hours.  When a rash is present in syphilis (like the spot on your wrist) all RPR tests are positive.

This is my 3rd response to your questions -thus as per Forum guidelines, this thread will be closed shortly.  Clearly the information I am providing is not helping your paranoia about having gotten syphilis from your close to no risk events despite having PROVEN that you did not get syphilis.  At his juncture I suggest you seek professional counseling to help you move forward from the guilt and anxiety you appear to be suffering.  Future repetitive, anxiety-driven questions may be deleted without a response.  EWH
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