[Question #9607] Should i be worried
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30 months ago
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Hello doc, last week i asked you a question and you were kind enough to answer me, after a few days of the incident i posted about last week i saw a really small red/lesion burn on the corona of glans of my penis
Its not an open sore and when i zoom on it it just looks like a small burn or lesion, i dont see an ulcer or like any kind of bump or something just a small red spot
Should this worry me?
Can it be a chancre? What is a chancre suppost to look like, can it be syphillis?
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Edward W. Hook M.D.
30 months ago
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Welcome back to the Forum. As you know, Dr. Handfield and I share the Forum and on this occasion I happened to pick up your new question. In preparing to respond I reviewed your earlier interaction with Dr. Handsfield and agree with all that he said. The encounter you describe was very low risk for acquisition of an STI and I would have recommended watchful waiting as well. I also understand how the appearance of a lesion would be concerning. You do not describe how large the lesion is or whether it has changed since it appeared. Whether or not you have applied anything to the lesion and whether you have had similar lesions would have helped as well. Finally, would you have noticed the lesion if you were not looking for it? This information would help.
Despite that however I'll provide some comments.
1. The interaction you described was very low risk. Most commercial sex workers do not have STIs and most single exposures even when partners are infected do not result in infection. The brevity of your unprotected exposure also makes this a low risk encounter.
2. The most common STIs which cause lesions are herpes and syphilis and your lesion really does not sound like either if these. Syphilis lesions go from visible raised lesions to open sores (the chancre) within a day or so of appearance and typically appear between 10 and 30 days (21 days on average) following exposure. Thus, this is a bit early to be syphilis which is rather rare as well among heterosexuals. Herpes lesions typically occur in clusters and become small, blisters with clear fluid which go on to become open sores within 24 hours of appearance. Herpes lesions most typically appear within 10 days of an exposure.
What to do. My initial impression is that this is unlikely to be an STI but at this time, I suggest that you need to be seen by an experienced clinician who can perform appropriate tests. If need be. For herpes the appropriate test is to have a swab specimen taken from the lesion and sent for PCR testing for herpes. Blood tests for herpes will not be helpful and may be misleading. Blood tests for syphilis may be negative in the initial 1-3 days after lesions appear but may be helpful.
Please DO NOT take antibiotics until you have been seen by an experienced clinician. Antibiotics will only confuse things.
I hope that these initial comments are helpful. EWH
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30 months ago
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hey doc, thanks for the reply
regarding the lesion ( im not a native english speaker so im not sure if lesion is the right now) its not exactly the lesions i see when i search on google google its just a really small red spot/area and not some sort of ulcer and cant be seen most of the time in room lighting , its unoticable but i was on the watch as doc handfield told me so i keep checking my genital area in florecent lighting in the bathroom, if i wasnt looking for it i wouldnt see it to be honest but if i look close enough or zoom with a camera i see a red spot, this has been since friday, it didnt get big or change (or maybe it did get a less noticable and i didint notice)
the fact that i still see it was getting me worried( i do masturbate without lotion every few days not sure if could be the reason its still there), weither i had simillar lesions in my life , again its not a lesion its like a red spot could be because of friction, i do remember having in my life something simillar but it wasnt on the corona of glans of the penis
another question, 8 days have passed since this incident, no symptoms of gonorreha or chylmida, is there any change i could experince any symptoms at this stage?
a small confession, im a rational man and i dont usually get too scared but this was my first unprotected exposure which is why im too worried and STI's are not very common in my country (its rarely talked about within heterosexuals), i did some research on HIV and syphillis in my country and both are pretty rare
there is 8500-95000 known cases of hiv in my country since the start of the HIV epidemic , 35% of whom are african migrants who seek refuge/work and 29% are Gay men and 15% are people who inject street drugs, around 660 women in my country have hiv and do not fall into the catagories above, there is 250-450 new cases of syphilis in my country each year most of whom (over 80%) are from gay men who come back home from vacations outside of the country
another stat is that 70-80% of all STI are found in tel aviv , my country's capital and is rarely found outside of the tel aviv area ( i do not live in the capital)
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30 months ago
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correction 8500-9500* known cases
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Edward W. Hook M.D.
30 months ago
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Thank you for the additional information. This is very helpful. Your message is clear.
With this additional information, it is far less likely that the spots that you have noticed were due to herpes, Syphilis, or any other STI. Red areas of the sort you describe or not uncommon on the penis, and could certainly result from chafing during masturbation or a minor, non-STI fungal infection. They certainly sound nothing like any typical STI, and may well have been present before you started looking at your genital genital area so very carefully. In our experience, it is not at all unusual for persons who are concerned about a recent sexual exposure to notice irregularities in the genital area that would have otherwise have gone unnoticed, and which may have been present for long periods of time.
While asymptomatic gonorrhea and chlamydia infections occur occasionally, most are symptomatic and result in symptoms within 5 to 10 days following an exposure. I have a little concerned about gonorrhea or chlamydia related to the exposure you described. Also, given the additional information you have provided both about your exposure and the epidemiology of HIV in Israel, HIV is not a concern here.
I hope this additional information is helpful. Please don’t worry. EWH
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30 months ago
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thanks doc, its been 20 days since the incident, no symptoms of chlymadia,gonoreha, herpes
also no symptoms of syphilis
the small red are aon the glans is still there though, it didnt change ofc and its not an open sore or a raised lesion its just a red spot.. but like you said if it was syphilis im assuming it would form as an open sore/ulcer by now which i would have noticed yes?,anyways thank you very much
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Edward W. Hook M.D.
30 months ago
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You are correct. If the rash you noticed on your penis was due to syphilis I would have expected it to form an open sore (an ulcer). The fact that it did not makes it far more unlikely that it is due to syphilis. If you are still nervous, you should test as a syphilis blood test would be conclusive at this time for ruling out syphilis.
Either way however, I would not worry.
This completes this thread. Take care. EWH
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