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Primary Syphilis Chancre on Neck?
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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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Primary Syphilis Chancre on Neck?

I'm a 30 year old male and have a hard cyst like lump on the front part of my neck, basically next to my Adam's apple at the throat, within my beard area. I'm worried this could be a manifestation of primary syphilis given an unprotected oral (both ways) encounter with a female escort CSW in London around 4 weeks ago? Have you ever seen a primary syphilis chancre on the lower neck? Is it possible?

Its very red, about 5mm across, has no puss at all, but is hard and if stretched has an outline thats white. At first I thought it was just an ingrown hair, and I guess it could be as I've a few other smaller red spots around the area (none anywhere near like this one), but following the episode above, I've become worried about it. Its been there about a week and still has no ulcer element to it (presuming thats the white part) I've seen online Syphilis chancres can appear anywhere, but mainly on the area of infection i.e. mouth/genitals - but have seen online they may appear anywhere, and it seems to be called the great imitator.

I've been tested for Chlamydia and Gonorrhea at 2 weeks and was clear on them (including oral swab) having shown no symptoms, I've also been tested negative for Syphilis at 3 weeks, but understand this is relatively pointless and plan on testing again at 6 weeks which I think I'm correct in saying should be conclusive? Ultimately though, could this thing be a Syphilis Chancre?

Thank you.
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Welcome to the STD forum.  My guess is you are under the care of a GUM clinic.  If so, I'm sure the following reply will match what they told you.  The UK GUM clinics are highly expert in all respects.

There is almost no chance such a lesion is a syphilitic chancre, as you were correctly told on the STD community forum.  Such a thing is theoretically possible, but few if any escort CSWs in London have syphilis, which is rare in the UK except in gay/bi men and occasional foreign immigrants; and rarely transmitted by oral contact even if she had it.  Certainly I have never seen such a case in 30+ years in a busy STD clinic, in a part of the world where syphilis is much more common than in London.

For reassurance, follow through with your plan for another syphilis blood test at 6 weeks.  It will be negative.

Regards--  HHH, MD
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Thank you Doctor. I really appreciated Vance's advice on the STD community forum, guess I just wanted some additional reassurance.

I haven't had the lump checked at my GUM clinic, as I didn't want to be a nuisance before going back for my 6 week test, hence why I posted here for some advice - all of which, as in the other posts I've read, makes a lot of sense.

Here's hoping it is negative.

Thanks again.
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