[Question #5872] RPR testing

19 months ago
Hey! I am a heterosexual white male, I have received 3 handjobs, a kissing encounter and condom protected sex that didn’t work due to an inability to get an erection (no penetration), that was about 8 weeks ago. After this event, I got a rash that made my penis swell and caused an itchy rash in the groin. The dermatologist said it was an allergic reaction and after reapplying the condom to my penis weeks later as a test, a rash appeared once again. I know there’s really no risk for syphilis and it was most likely an allergic reaction, but I got an RPR test anyways at 8 weeks post, I also got tested for HIV 6 weeks post, both negative. Can I rely on these results? I also took 250 mg of Medrol over 6 days, 8 weeks before my RPR, in addition to an oral dose of decadron a week before the same RPR, will any of these influence my test? Or can I be sure I am negative for syphilis? I had a baseline negative RPR 5 months ago which was also negative. Thank you!
19 months ago
Also, should I consider the prozone effect? Or does my negative HIV test 6 weeks after the pretty much no risk event make that unnecessary 
Edward W. Hook M.D.
Edward W. Hook M.D.
19 months ago
Welcome back to the Forum.  It appears that you have now shifted your concern regarding the no risk encounter we discussed previously regarding your HIV test results to worrying about syphilis.  I hope that the information I am about to provide you will help resolve your concerns.  Several comments in no particular order:

1.  Your rash and its recurrence following application of a condom a 2nd time is a classical description of an allergic reaction, most likely to latex which is what most condoms are made from.  Latex allergy occurs in about 7-8% of the population.  FYI, there are non-latex condoms made of polypropylene  which are highly effective and do not cross react with latex.

2.  Nothing about the rash suggests syphilis

3.  Further, your exposure was virtually no risk for syphilis, as was its context.  FYI, there will be fewer new cases of syphilis in the US this year than new cases of HIV and 80% of those will occur in men who have sex with men.

4.  You should not worry about a prozone reaction- it is a very rare event, which would typically be expected to occur at the time of the rash, this is not the case for you.  

5.  Your steroid ingestion does not make your RPR results less reliable.

I hope that this information is helpful and will help resolve your concerns.  EWH
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19 months ago
Thanks Doctor! I really appreciate all of this information. So based on my negative RPR taken 8 weeks after these low/no risk events, I don’t have syphilis?
Edward W. Hook M.D.
Edward W. Hook M.D.
19 months ago
Correct.  Nothing to worry about, time to move on.  EWH---