Red spot

[calidebate]

I am an uncircumcised male.   Approx. 4-5 weeks ago I was with a female friend that I had known for some time and we had a single episode of unprotected sex. Late this week I noticed a red spot at the base of the head of my penis as well as a mark on the inside of my foreskin that would be in the same place as the spot on the head when the skin is not retracted.  The spot on the head of the penis has since gone away but the spot on the inside of the skin is still there.  There is no puss. It might be very slightly raised.  The woman I was with has since told me that she has had a full work-up done and that she is clean, and while I would like to believe her, I don't want to simply take her word for it.  Prior to being with her, I had a full blood work-up done in December of 08 and was clear of all STDs at that time.  

(1) What are the chances of having contracted something from this single incident; and
(2) while I know that you are working with relatively limited information, what does it sound like I might have -- should I see my physician for another round of testing?

if you need additional information, please let me know.  Thank you for your service!

[Edward W Hook, MD]

What you describe does not sound like an STD.  The location and description sound much more like normal skin structures than infection. This might be a benign coetaneous cyst, a mucous gland, or pearly penile papules.  It is likely that it may have always been there but that you just noticed it; this actually is not uncommon. Alternatively, there is an outside chance that it is a wart.

Regarding your first question, your chances of getting and STD from exposure to a new partner are influenced by a number of things. these include her chances of being infected, how many time you were exposed and whether or not a condom was used.  She says she has been checked and is not  infected.  Most people do tell the truth so I would believe her. In addition, even with infected partners, it turns out that the majority of exposures do not lead to infection.  Finally, condoms are always a good idea.

I hope these comments are helpful.  You have little to worry about.  If my comments don't give you complete peace of mind, you might go see your doctor or a local STD clinic and have them take a look.  

Hope this helps.  EWH

[calidebate]

Thank you for your insight.  Is there anything you can tell me regarding the wart possibility?

[Edward W Hook, MD]

No, there really is nothing more to say until you get examined.  The chance that what you describe is a wart is, as I said, small and I will not waste my time or yours on conjecture about a hypothetical situation.  It is not in your best interest.  EWH

[calidebate]

Dr. Hook,

I have appreciated your advice this past week.

Let me lead this off by saying that I was still worried about the wart possibility and read that vinegar could be used to diagnose/ reduce the size of the warts.  Stupidly, on Sunday I applied a decent amount of vinegar to the area, at one point even taping a cotton ball soaked in vinegar to the area).

On Monday morning, the area had additional red spots (approx. 3 additional spots, the initial spot looked more inflamed and the general area was red, however the spots were not lesions nor leaked puss).  I contacted a urologist and saw him on Monday.  He thought that the spots looked herpetic and drew blood to check for herpes (he ran a IGG and IGM test) as well as HIV. hep C, & syphilis.  All of my results were negative.  He told me to stop the vinegar and apply neosporin to combat possible chemical burn.  Throughout the week, the spots have varied in their redness and whether they are raised or flat (sometimes the spots are not even visible).  

The urologist recommended a wait and see approach to see if they go away and to come back next week if they don't.  The urologist has very good credentials, I trust him, and I will follow his advice and go in next week if they are not gone, but I wondered if I could pick your brain to see if you might have any ideas so that I can prepare myself for whatever the possible diagnosis is.

Thank you!

[calidebate]

sorry, forgot to add, the reason that I am writing this tonight is that all 4 red spots are very pronounced (well defined and red, some are slightly raised and others are flat).

[Edward W Hook, MD]

For starters, let me point out for you and other readers that the "vinegar test" is VERY unreliable and in fact studies have shown that over half of skin spots which turn white with application of vinegar turn out to not be HPV.

I really cannot not comment on what this might be.  From a distance, what your urologist says makes total sense.  This is almost certainly not an STD and in all probability, it is some sort of normal skin variation or a benign process, possibly irritated by the application of vinegar which is dilute acid.

I urge you not to worry.  EWH