Wondered if you can help me. 

Around 5 week ago I had a sexual encounter male on male. I believe you will class the encounter as no risk or at the very most very low risk. But since developing some sort of symptoms I would like to clarify. I have spent time reading this forum and I am very very impressed with how it’s run and trust you with my risk assessment and subsequent action going forward. 

The encounter was hand jobs mainly. It abundance of caution we did keep ourselves to ourselves most of the time (I pursued this he did not) we did swap hands and played with each other but the “back and forth” was limited. 

Then on climax he took me by surprise and finished on and around my face. I as quickly as I could wiped this off while I waited for him to get me a wipe I kept my eyes and mouth as closed as I could. 

Now 5 weeks after I have a spontaneous cut like leasion in the corner of my lips the joint part. There is no reason for this that I can think of. It’s only on one side.  It hurts especially when let’s say yawning or eating. It feels moist but dry. And it scabs in a morning before opening back up over the day. 

I feel there is a high likelihood that his sperm did make contact with this part. 

What’s my chances here all things considered is this syphilis? 

You are right to be concerned about syphilis and take steps to avoid it. It's the most dangerous STI aside from HIV and, like HIV, most likely to be deadly and most common in men who have sex with men. However, you needn't be concerned at all about the exposures described and the oral sore you describe. The main anatomic sites for an initial syphilis lesion (chancre) are the penis, the vaginal opening and labia in women, anus in people who have receptive (bottom) anal sex, and less commonly, the mouth. There is good reason for these locations:  all are subject to friction during sex. Large amounts of the bacteria that causes syphilis, Treponema pallidum, usually must be massaged into exposed tissues in order for infection to take hold. The required amounts of T pallidum, and the necessary friction/massage, are absent in the sorts of exposure you describe. In theory, it remains possible that such events could transmit infection, but with extreme rarity if at all:  I have never seen nor even heard of anyone with syphilis whose only potential exposure did not include vaginal, anal or oral sex.

The sore at the corner of your mouth sounds like typical angular cheilitis. You can google it to see photos (being aware that online clinical images, whether angular cheilitis or anything else, tend to be more dramatic than the average cases). Some angular cheilitis is due to specific causes, and it is common in people with immune deficiencies of various kinds, but occasional random cases are most common and usually have no specific known cause. Typically it heals on its own within a week or two.

So I am confident you do not have syphilis. If you have had similar symptoms before, i.e. might have recurrent angular cheilitis, and if at risk for HIV in general (like many MSM, although not from this exposure), and if you haven't been tested recently for HIV, that would make sense. But I see no need for syphilis testing or for concern about it.

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

HHH, MD

That clears everything up. In fact more so than I even hoped. 

I tested for HIV just before this encounter so I think I’m ok. 

I’ll just move on then. 

I am so so so sorry to be back, truly sorry. I really am not second guessing you please don’t think for a minute that I am. 

I hate myself for even asking this! But here we go. 

I have googled angular cheilitis and I agree that diagnosis seems to spot on, brilliant work. 

Unfortunately it seems on some sites at least that angular cheilitis at one side of the mouth (like mine) is a sign of secondary syphilis. 

I promise I have not been looking everywhere for this it was in plain sight

Can you expand on this, am I too early for secondary syphilis, do you agree it’s a sign. 

I don’t even know what I’m asking here. I’m not going to make you repeat the fact that I did not put myself at risk. 

These questions surely are redundant but I find myself asking anyway.

So so sorry. 

Since you obviously are still concerned (and likely will remain so despite my advice), why not have a syphilis blood test? A negative test at this time will prove for sure that your cheilitis isn't syphilis; and another test at 3 months after the event described will prove you don't have syphilis of any stage.

I’m absolutely do trust you.  That’s why I’m asking these question. 

I can’t get access to free testing so I’m going to wait until my next routine test rather than rushing out and panicking over a no risk encounter. I did test for syphilis in my annual start of the year. 

But just to summarise 

1) exceptionally low risk encounter that you have never seen or heard of. 

2) the sore on my lip dosnt really sound like either a syphilis chancre or any form of secondary syphilis

3) it’s too early 5 week for secondary syphilis and probably too late for primary. 

4) a cut like lesion (thin and long not round) dosnt sound like syphilis. 

5) it seems to be getting a little better already (almost a week) certainly not worse or changing. Which again dosnt really for with what I have read up on. 

So all things considered. 

Move on.

I know this will close when you reply so please once more thank you so much. I have enjoyed our interactions and was good value for money. 

That concludes this thread. I'm glad the discussion has been helpful. Best wishes and stay safe.