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One sore on penis, then a second -- syphilis or folliculitis, or other?...
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The STD Forum is intended only for questions and support pertaining to sexually transmitted diseases other than HIV/AIDS, including chlamydia, gonorrhea, syphilis, human papillomavirus, genital warts, trichomonas, other vaginal infections, nongonoccal urethritis (NGU), cervicitis, molluscum contagiosum, chancroid, and pelvic inflammatory disease (PID). All questions will be answered by H. Hunter Handsfield, M.D. or Edward W Hook, MD.

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One sore on penis, then a second -- syphilis or folliculitis, or other?

I have read this website extensively, and thank you for your devotion and considerate answers to the questions here!

OK, my situation:  About 15 days ago pimple-like lesion (about 2-3 cm) appeared (first a red swelling, then head on the pimple) near the base of the shaft (on top) of my penis.  It is red and indurated, but not particularly pus-producing.  There was a hair coming out of it, which after a few days I pulled out.  The lesion then produced a very small amount of pus (perhaps) and then scabbed, and the scab turns white in the shower.  There does appear to be a bit of an indentation, though it doesn't look like the "craters" I've seen in syphilis pictures (though I have read that chancres can have varied appearances).  The lesion remains, 15 days later (though it appears to be slowly healing - hence I am thinking it's not herpes).

4 days ago (11 days after the initial "pimple") an identical "pimple" appear adjacent to it, though with no protruding hair.  That one seems to be healing already (small scab).  The scab has since fallen off the first pimple, but the appearance is still of a lesion - blister or pimple of some sort.  

Though scared that I might have contracted syphilis (I have been quite sexually active during the past 90 days, shamefully I admit sometimes with professionals and not always with protection), I have done nothing yet to treat these, other than wash and sometimes use Mycitracin initially (didn't appear to help).  I'm simply too scared to see a doctor right now in the country where I currently visiting.

So, in the meantime, I would be greatly appreciative of your best-guess diagnosis (es) and any home treatment recommendations, to the extent that you can make them from the info. I've provided.  And FOR SURE I will get tested soon (for all STDs) -- if you recommend, I will even do it before I return to the states in 2 months.

Thank you, sincerely.
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I always avoid trying to make specific diagnoses by online description, even "best guess".  And I absolutely will never recommend any kind of home-treatment or self-treatment when the diagnosis is unknown.

Syphilis is rare in heterosexuals (including sex workers) in most of the US.  For practical purposes, it is limited to gay men and their partners.  A pimple-like lesion does not suggest syphilis, but it is possible. Herpes may be a better bet.

Bottom line:  Do not attempt to come to any certain diagnosis online, whether in this forum or elsewhere.  See a health care provider.  

HHH, MD
7 Comments
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Avatar_n_tn
I meant to also say that there had been no itching, burning, or any kind of symptoms regarding urination.  Also, when I mention "hence I suspect it is not herpes" it is because of the duration (more than two weeks) of the lesion, because it started as simple lesion and only recently became a second, and because I've never had a herpes outbreak before.  Of course I am only basing my conclusion on assumptions made from things I've read, so perhaps I should have titled this "syphilis, folliculitis, HERPES, or other?  Thanks again, and sorry to have been so loqucious.
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Avatar_m_tn
I would suggest consistent protected sex the rest of the time you are over there in the third world country or the pimples might be the least of your worries.
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Avatar_n_tn
Yes, certainly (though I'm not in a third world country).  I am certainly aware of the risks I have taken.  I have sought out psycological counseling since I am cognizant of my foolish behaviors, just not fully aware of why I did them.  Best wishes.
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Avatar_n_tn
You hit the nail on the head -- I really just need to go get checked out.  I guess I am still curious whether Herpes lesions can persist for 3 weeks (i.e. more than 7-10 days, as you've otherwise said in this forum a number of times).

Again, thank you sincerely for your wisdom and your considerate replies to everyone on this forum.  While I agree that this cannot be a replacement of in-person medical diagnostics, I have learned a lot from reading your comments here, and believe many others have too.  Best wishes.
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Avatar_n_tn
Also, to generalize the question so as to benefit all readers, the things I haven't been able to figure out (from reading extensively here and on other sites) are:

1. do herpes lesions ever occur as a single (or only two) lesion and can they last much longer than 10 days (e.g. 3 weeks)?

2. do herpes lesions ever NOT itch, tingle, burn, etc.?

3. how common is bilateral swelling in groin area lymph nodes (symptom other than chancre) when syphilis is contracted?

4. how do syphilis cancres heal (I have found NOTHING about this) -- I mean what does the process entail and look like?  And can a second chancre suddenly appear?

5. how common are folliculitis (and/or pimples) on the penis shaft?


I hope these questions might better benefit all readers than my initial question (and perhaps save you some questions too).

Best regards.
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239123_tn?1267651214
Herpes sometimes presents with only 1-2 lesions that can be painless and herpes persist for as long as 3 weeks, especially with the initial outbreak.  Chancres just gradually fill in with fresh, normal skin.  Syphilis often causes bilateral lymph node swelling.  Pimples are common on the penis.

None of which modifies the need for you to be examined.  Do it right away; the longer you wait, the harder it will be for your provider to make an accurate diagnosis.  I will respond to further questions after you have seen your provider, not before.

HHH, MD
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A related discussion, sores on shaft was started.
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