[Question #4747] Std help

25 months ago
Hi. I had unprotected sex with am ex gf on November 21. On dec 2nd i noticed a sore on the tip of my penis. Not sure how long it had been there but thats when i first noticed it. Its flat ,not open, smooth n has a rosy flesh color. It also does not hurt.its now dec 28 n it still looks the same. I took a syphillis test soon after i noticed the sore and the results were negative.  I started getting headaches and mild nausea( was very strssed and felt high anxiety) so i took another blood test for syphillis on the17th which also was negative. Should i continue testing for this?. Also took an Hiv rna test on the 19 of december 27 days after possible exposure.  Is this reliable or should i take another test?
Edward W. Hook M.D.
Edward W. Hook M.D.
25 months ago
Welcome to our Forum.  I'll do my best to help.  Your lesion appeared 12 days after your exposure to your ex as a flat. smooth lesion which has now persisted for nearly four weeks without changing.  This would be late for a herpes lesion to appear and the description you provide does not suggest herpes.  Syphilis can cause lesions within the time frame you describe but again, the appearance is uncharacteristic for syphilis which would typically cause an open sore.  A lesion of this sort could be a manifestation of something as benign as a fungal skin infection of an unrelated dermatological problem.  My advice is to seek evaluation by a trained clinician who can examine you.  If this were syphilis, your test on the 17th could almost certainly have been positive.  

As far as HIV, this was a low risk exposure as the disease is quite rare in women and does not cause lesions of the sort you describe.  Your HIV RNA test at day 27 is likewise conclusive and proves that you did not acquired HIV.  

I think the best thing you could do is seek evaluation, perhaps by a dermatologist if you have access of, if not by a clinician who is experienced in looking at genital lesions.

I hope this comment is helpful.  EWH
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25 months ago
Thank you for your answer.   Would an open syphilis sore scab with time and normally how long would the sore last.  Do u think i should take another test or would i most likely have a negative result .
Edward W. Hook M.D.
Edward W. Hook M.D.
25 months ago
Syphilis sores do not typically scab over- they heal over a period of 3-4 weeks.  A repeat syphilis test would definitely rule out the possibility but I think it is highly unlikely that this is syphilis.  MY guess is that it is some other sort of dermatological problem.  EWH---
25 months ago
Thank you doctor. Made an appointment for the 2nd of january. Reading up on STDs online can get very confusin due to sources all saying different things. Regarding siphillis some sites say they can last up to 8 weeks is this true. Also could u firther explain to me what the typical siphillis sore would look like?  I also took another blood test on the 29 just ti he sure.  These are my final questions.  Thanks!
Edward W. Hook M.D.
Edward W. Hook M.D.
25 months ago
Much of what is present on-line is confusing and all too often, incorrect.  A few things to remember about syphilis"
1.  the diseases is rare, particularly among heterosexual men and women (of 2/3 of syphilis in N. American now occurs in men who have sex with other men).
2.  The manifestations are highly variable.  If there is concern, the blood test is a the appropriate decider.  If your 12/29 test is negative, as I anticipate it will be, be confident you do not have syphilis.
3.  Because the disease is rare, people tend to be overly cautious, making statements lime a syphilis sore can last up to 8 weeks- this is an overstatement.
4.  A classical syphilis sore is a shallow, non-tender, clean based ulcer.  If it firm to the touch.

This will complete this thread.  Because I am interested in what the dermatologist has to say, I will leave the thread open and ask you t report what the dermatologist says.  I am confident he/she will not think this is syphilis or, for that matter, any STI.  Please let me know.  Until then however, there will be no further replies.  EWH  

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