[Question #9237] Syphilis or another STD?

34 months ago

On July 31st I saw a high-end escort that I have seen multiple times. During sex I noticed a fishy smell coming from her vagina while I was penetrating her wearing a condom. I also noticed three small round spots on sole of her feet located between her heel and mid sole. After I was done I went to the shower to take the condom off and it smelled like fish and I jumped into the shower to wash off which made me really worried. When I came back outside she was looking at the condom box and said she was never going buy these condoms again cause they smelled and she also jumped in the shower. We talked after and she noticed I was uncomfortable and told me she gets tested every 3 months and was trying to get the monkeypox vaccine to be on the safe side. She said her last test was middle of June and my yearly STD test was middle of July with all negatives.

I got really paranoid when I came home and started doing research and got worried I might have contracted Syphilis. Ever since that date I kept looking for a rash or chancre sore. I have not seen a chancre sore but today I saw a rash that looked like skin peeling in my right inner thigh that touches my scrotum. At first glance it looked like a typical hair folliculitis I get since I’m a hairy guy but it looked different. I started to rub it and noticed the skin just peeled off as I rubbed it. I thought it might be jock itch and put clotrimazole and Betamethasone cream that I was prescribed for fungal infection. Couple of hours after I put it the peeled skin look and feel seems to go away and I now see there are red spots. I have no rash on my palms or sole of feet. I do have couple of pimple like bumps on my buttocks that feel like a typical hair follucilitis. I do workout a lot and a lot of times I don’t immediately take a shower.

Does my groin rash sound like syphilis?

Can I get syphilis rash without anything on my palms and sole of feet?

How long should I wait to get tested for syphilis?

Does this sound like any other STD that would warrant for testing?

Thank you.

Edward W. Hook M.D.

34 months ago

Welcome to our forum. Thanks for your questions. I’ll be glad to comment. Before I do, let me remind you that most high end commercial sex workers are quite careful about STI‘s, pursuing regular routine testing and kind of protected sex both of which your recent partner reported. As a result sex with a partner of this word is probably a lower risk event than sex with a casual partner met at a bar or other social event. In addition, condom certainly can’t have odors of their own which might be what you experienced during your encounter.

Regarding Syphilis, this disease typically evolves through a series of stages in untreated persons. The initial lesion of syphilis, the chancre, is a painless, usually solitary genital lesion that occurs at a site of direct sexual contact. Primary syphilis lesions occur most often about three weeks after the exposure. Without therapy the chancre may resolve and the disease moves into the second stage which is characterized most often by a rash. Rash of secondary syphilis may be highly variable however a rash occurring on the inner aspect of the thigh would be an unusual rash for secondary syphilis. The rash of secondary syphilis does not need to occur on the palms or soles.

If your rash we’re due to syphilis which is most unlikely, syphilis blood test would be positive at this time. In persons who have not noticed lesions orthe disease can be definitively ruled out with negative blood tests 6 to 8 weeks following an exposure.

Overall, I would consider the encounter you described quite low risk and the possibility that you have syphilis, or for that matter any other STI is most unlikely. As I said above, if you wish to be entirely sure that the rash you have noted is not due to syphilis, get tested at this time. A negative test will prove that Your rash is not due to syphilis. Otherwise you can wait until 6 to 8 weeks following the encounter to get a blood test to prove that you did not acquire Syphilis.

I hope this information is helpful to you. If any part of my responses unclear or they are further questions, please don’t hesitate to use your opted to follow ups for clarification. I would not worry. EWH

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34 months ago

I put clotrimozole, cortizone, and petroleum jelly on it for two days and now the peeling has gone away along with most of the redness. The rash is small and it is located right where my scrotum touches my inner thigh. I can't get tested right now cause my current location has a clinic with bunch of employees that know my significant other. I have to wait until I get back home to get tested.

Thank You Dr. Hook.

Edward W. Hook M.D.

34 months ago

The rash that you describe it really sounds nothing like Syphilis or any other STI. Please don’t worry. EWH---