[Question #5749] Syphilis - worried

19 months ago

Syphilis – going out of my mind (erotic massage)

Dear Doc,

The fact of the question are I had an erotic massage from an independant CSW in the UK around 4/5 weeks later I noticed a spot/sore/chancre not sure which in my pubic region around 1 inch away from the bottom of my penis shaft. It was only around 3/4mm in size, didn’t really have any pain and could feel a bit of a lump under the skin, at one point I think I played with it and it kind of developed a scab. Just over two weeks down the line now and it has almost gone, no lumpy feel to it just a red circle now which is fading day by day and does appear to have kind of a tiny yellow spot on it just of centre but can see any puss as such

In the massage I recall her rubbing her groin against mine briefly and not really vigoursley.

Would it be possible for syphilis to penetrate the skin here without lots of massaging into the skin.

Does it sound like syphilis from the description of the sore?

I also feel like I have some discomfort in the urethal area, although not when urinating just in general although this could be totally in my head.

Having read many questions on medhelp where it is stated that it is vanishingly rare for transmission to occur with penetrative sex and one expert said they had not seen a case where it was transmitted in this way in over 30 years. I know there is a theoretical risk how real is this risk in my circumstances.


19 months ago
sorry that should say 3-4mm not three quarters.

thanks
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
19 months ago
Welcome to the forum. Thanks for your confidence in our services.

Almost certainly you do not have syphilis. Heterosexually transmitted syphilis is rare in the UK, and hence very rare in female sex workers and in women in general. Hand-skin contact is an extraordinarily rare transmission mechanism, if it ever occurs at all. And as you suggest, the apparent light and brief contact with the involved site argues against syphilis. Finally, if I understand your description -- a skin bump that might have started to open up from irritation from repeated manipulation -- doesn't sound at all like a chancre.

So I'm not sure I would put your case even in the "theoretical risk" category. At a personal level, if I were somehow in your situation, I would not even get tested for syphllis, based on what I know so far. That said, of course htat is exactly what you should do:  have a blood test. (Many anxious persons are more reassurned by negative testing than by professional opinioin, no matter how expert.) It sounds like the massage was >6 weeks ago, in which case a blood test now will be conclusive. You can expect a negative result. 

As for your urethral/penile "discomfort", syphilis would not do that; and if you don't have discharge, you can be sure you don't have urethritis (gonorrhea, chlamydia, NGU) -- and could not have acquired these from the events described. Finally, whenever someone suspects her/his own symptoms have an emotional origin ("this could be totally in my head"), almost always s/he is right.

So get the blood test. Feel free to return with a follow-up comment to let me know the result. In the meantime, I hope these comments are helpful. Let me know if anything isn't clear.

HHH, MD
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19 months ago
thanks for you reply and if you have understood my position then this certainly does make me feel better.

can I just clarify you say "Hand-skin contact is an extraordinarily rare transmission mechanism" where in my question i put "I recall her rubbing her groin against mine" so it was not hand skin it was her groin albeit brief.
 
hope this does not alter opinion of "So I'm not sure I would put your case even in the "theoretical risk" category. At a personal level, if I were somehow in your situation, I would not even get tested for syphllis, based on what I know so far" 

i have ordered a blood test to be on the safe side

Many Thanks
19 months ago
just to add some substance to this by groin I mean vagina, like I say briefly
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
19 months ago
Sorry I misunderstood that detail. But my comments apply to any skin-skin contact. Even direct genital contact, including genital moisture, would be no significant risk in this situation.

You can expect a negative blood test result. As already offered, feel free to let me know the result -- but I won't have any further comments until then.
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