[Question #8026] Rash, Genital Rubbing
49 months ago
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So 4 and a half weeks ago I visit a "masseuse" unprotected oral, handjob and genital rubbing. She confirmed no penetration occurred. It was difficult to tell due to the moisture. Fast forward to this week. No fever. No sore throat. My one side the lymph node in the armpit felt somewhat sore. But a red raised rash. Not itchy. Sometimes burning. On the center of my chest, about 3" around. A splotch on the one side with the gland. And another 3" on my back. I went and got it looked at and the PA didn't give anything definitive. Just gave a steroid cream and prednisone. So of course I google and start freaking out.
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H. Hunter Handsfield, MD
49 months ago
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Welcome back to the forum. Thanks for your continued confidence in our services. I'll be managing this question, but I reviewed your two discussions with Dr. Hook a couple of years ago and agree with his advice -- which is pertinent because I see parallels between those questions and his responses.
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Among Dr. Hook's comments last time you were on the forum were these: "Genital-genital rubbing (frottage) is a no risk event for HIV and STIs" and "Mutual masturbation is a no risk event, even if partners get each others' genital secretions on one another." I'm pretty sure you understood the low risk -- but certainly understand how your new symptoms could raise your concern. However, those symptoms are not typical for any STI, including recently acquired HIV (which I imagine is on your mind). I'm confident they are merely a coincidence and not at all related to the massage events a month earlier.
And I think you have already confirmed that google and the internet aren't necessarily your friend in these circumstances. I imagine you've seen lists of HIV and STI symptoms and found things like skin rash associated with HIV, syphilis, etc; or perhaps comments about supposed risks from the kinds of sexual contact you describe. I can assure you that you can pretty much ignore them. Sure, rash is listed as a symptom of acute retroviral syndrome (ARS, i.e. new HIV infection), as well as syphilis. But that doesn't mean just any rash: both ARS and syphilis cause particular kinds of rash, which do not fit at all with your description. The timing is also much too late for ARS, and too soon for syphilis: ARS symptoms always begin within 8-15 days of exposure, and the rash of secondary syphilis cannot appear sooner than about 6 weeks.
So you can stop worrying about HIV or other STIs from this event. You don't need to be tested for anything. (That said, from both this and your past questions, you're certainly on the edge of potentially risky exposures, and anyone who is sexually active outside a committed, mutually monogamous relationship is well advised to be tested for common or serious STIs -- i.e. urine for gonorrhea/chlamydia and blood tests for HIV and syphilis -- from time to time, such as once a year. If you haven't been tested for a while, you might consider it now -- but not because of the exposure described above. If that's your only sexual experience in the past year or two, feel free to skip it!)
I hope these comments are helpful. Let me know if anything isn't clear.
HHH, MD
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49 months ago
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Thank you for the reply, and you are correct there is too much bad info out there, one website was using a stock photo image as an example of the rash, and then some websites say it is itchy, others say painful others still say neither.
So how does it typically present? Is it a spreading rash or the entire area at once? Itch/no itch?
I went out and bought an oraquick test and it did come up negative.
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H. Hunter Handsfield, MD
49 months ago
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The typical rash is maculopapular, meaning red spots -- either flat (macule) or slightly raised (papule), usually under 1 cm in diameter, most typically of the face, trunk, and arms. although any body area can be involved. Usually not itchy. However, it can be quite variable. You can find images online (google "ARS rash photos" or similar wording), but be aware that online images of any skin condition tend to be exaggerated -- typically mild cases are less interesting than more dramatic ones, which tend to be overrepresented. In any case, your negative oral fluids test proves that something other than ARS is causing your rash. (ARS symptoms are caused not by HIV itself, but by the immune response to it. Therefore, the HIV antibody tests are always positive in presence of ARS symptoms.)---
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