[Question #8298] Syphilis Questions

46 months ago

I am a male heterosexual. After recent oral exposures, I developed a bump on the bottom part of my penis head. I initially thought it a wart or something I got from having rough sex alot with my partner in a short period of time. This remained as a bump for about 2 months (painless). Recently, it has turned into a scab after over 2 months of bump status. It seems to be now scabbing and I dont recall it turning into an ulcer or anything in the middle. Just went from Bump for 2 months to suddenly scab in the middle , skin broken out. From initial time bump appeared until now has been 2.5 months. Could be irritated by soap masterbation?

1) Does this seem like it could be syphilis? Could a syphillis bump stay a bump for 2 months until skin breaks down? I thought it turns from bump into ulcer within a couple days if it is syphilis.

2) If it is, could I have transferred it to my partner while having unprotected sex while it was still bump status (not scab yet)? Also its been dry throughout, I dont ever recall it being wet or oozing.

3) Would tetracycline (lymecycline 300 MG) ( prescribed for acne) 1 dose a day for 32 days, get rid of the infection if I indeed transferred it to my partner? (this was perscribed for something else)

H. Hunter Handsfield, MD

46 months ago

Welcome to the forum. Thank you for your question and your confidence in our services.

I'm not certain what has caused the bump, but I am very confident it isn't syphilis. The best bet is some sort of skin irregularity (fibroma, enlarged skin gland, etc) . I suppose a genital wart also is possible, but single warts are uncommon. Whatever the initial cause, maybe it became irritated for some physical reason, perhaps masturbation, depending on the vigor and style of masturbation. But syphilis is exceedingly unlikely on clinical grounds, and impossible if you have been taking lymecycline for more than the past week or so (more about which below).

Those comments pretty well cover your numbered questions, but to assure no misunderstanding:

1) Syphilis would not cause such a bump that would later have skin breakdown.

2) In the extremely unlikely chance it were syphilis, your partner would definitely be at risk and would need to have diagnostic testing and treatment.

3) If you have been taking lymecycline for acne and were doing so during the oral sex events, that makes syphilis even more impossible. It for sure would have prevented infection -- or if started after the bump appeared, would have cured it and the bump would have cleared up entirely in a few days.

You could consider having a syphilis blood test; a negative result would prove you do not have syphilis and never did. However, if you were indeed taking lymecycline during the exposures, you can entirely dismiss syphilis and testing isn't needed (except perhaps to increase your own confidence you don't have it).

My final suggestion is to see a doctor, ideally a dermatologist, to diagnose the problem. In the meantime, don't worry about syphilis.

I hope these comments are helpful. Let me know if anything isn't clear.

HHH, MD

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46 months ago

Hello Doctor, thank you for the answer I have follow up questions

1) Have you come across a case and is it possible for a syphillis to start as a bump and stay as a bump for 2 months before it ulcerates or scabs? I noticed this bump after having sex with my partner 4 times a day for 3 days and sometimes was dry and no lubrication. Also masterbated a lot with soap. Could this be related?

2) if indeed this bump is syphilis, I’ve had sex with my partner with the bump. After having sex, she is the one who started treatment for acne and not me. Let’s say my bump was syphilis and she started lymecycline 300 MG once a day for 32 days AFTER we had sex. Would this cure her syphilis? Is the dosage appropriate? Does she need to test?

H. Hunter Handsfield, MD

46 months ago

1) No, I have never come across such a case. But I have no further guesses about the actual cause of the bump, beyond what I said in my initial reply. I would suggest you carefully avoid potential irritation for a week or two and let the inflammation heal -- then see a doctor about it.

2) Sorry I misunderstood that it's your partner taking lymecycline, not you. That makes it impossible that she has syphilis. Lymecycline is not normally used to treat syphilis, so I cannot say what a curative dose might be for established syphilis. However, all drugs of the same class (the tetracyclines) are active against syphilis, and any dose at all would prevent syphilis if being taken during exposure, and probably would cure syphilis.

Given your heightened concern, and since you're not the one who has been on lymecycline, I strongly urge you to just have a syphilis blood test. It's clear you are obsessed with the possibility of syphilis, and a negative blood test undoubtedly will go a long way in convincing you. Let's make this the last question/comment in this thread until you are tested. I'll be happy to have a final comment if you do that and would like to post the result. It would be great if you also have seen a doctor and can report what s/he tells you. But I will have nothing further to say until that and/or a blood test result. OK?

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