[Question #3965] Follow up

31 months ago
So. 21 days ago I had oral sex on me by a asian massage woman. I have what looks like a ring worm or fungus I guess on my shaft.  She put a condom on me with her mouth but as she did it, her mouth went over the condom a bit.  I had this type of rash in November and in February.  In February I asked you about your opinion and to see if it was syphilis.  You said no you did not think so.  Additionally, I had a doctor take a lool at my rash in February and she gave me some cream. I think what is going on is that I had intercourse with my regular female partner this past Saturday. The rash came on on Monday. I am uncircumcised and do not wipe my penis after intercourse. I just put my underwear back on.  I think this may cause the fungus. i dont know. The rash has not become a chancer or no sore. I do have HSV 1 so I am not worried about this. I am trying to be logical. Here is my logic. There are only about 10,000 new syphilis cases in the US. About 7000 are from male on male. About 3000 are from females. Most are in the SW. I live in the SE. I would say 2000 of the 3000 are in the SW. This lives about 1000 females left for the SE, NW, NE and any where else. Out of the 1000, let say 700 are from genital infections. So we have 300 from oral. Out of 300, lets say 100 are in my state that have 4 million people. Out of 100 lets say 20 have a lesion. Out of 20 lets say that 10 are massage workers. So my chance is that may be I could have had 1 of the 10. I did look at her mouth and did not see a leson. Maybe she had it in the back of her mouth. Regardless, the condom was put on me by her mouth and it immediately covered my head and most of my penis. I think with the statistics and me not developing a sore, it is safe to say that I did not catch syphilis. I am unable to see dermatologist because it takes a while for them to give you an appointment and I am flying out today and will be gone for a week. If i pull the skin down and apart, it looks normal. If I look at it, it look
Edward W. Hook M.D.
Edward W. Hook M.D.
31 months ago
Welcome back to the Forum.  You do not appear to have completed your post and I'm not sure I see a specific question here.  Nonetheless, while the concerns you express relate to a newer, more recent exposure, the situation and circumstance are quite similar.  Several months ago I provided you with responses indicating why it was that the lesion/rash you described was unlikely to be syphilis and that is still the case.  In addition, in this post you now apply statistics to your reasoning.  While I agree with the figures that you have described which validate just how unlikely it is that your rash is syphilis, I think your figures are overly conservative and can assure you that oral syphilis is far, far less likely than you estimate.  Furthermore, the similarity of this episode to your prior one is strongly suggestive that this is a chronic, recurring dermatologic problem rather than an acute, recently acquired syphilis infection.

I urge you not to worry that the lesion you are describing is syphilis and to move forward without concern.  When the opportunity arises, see a dermatologist who can help you address the problem.  EWH
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