Sore on penis

[ndhlp1]

Dr HH / EWH,

I just noticed while taking a shower that I have a small red sore on the side of my penis which looks like a sore that resembles an area where skin came off and it's sensitive to the touch. I noticed it because while washing my penis with soap it felt sensitive to the soap.

I also have some pain in my neck for the past 2 days (more today than yesterday) which I'm afraid might be lymph nodes. It's not swollen but it hurts when I push a little on that area or when I turn my head etc. It's on the left side on the front of my neck.

I started worrying a lot and reading about possible STDs and found that the penis sore and lymph nodes could point to syphilis. I'm so worried now!

I have a new partner since end of January and we have protected vaginal sex with condoms and unprotected oral sex (I'm a recipient).

I'm so worried now!!! Could it be syphilis or some other STD??? I'm also worried that if we have unprotected oral sex, am I at risk of HIV? I think I've read that oral sex is a very low risk activity but I recently found out that she had a tooth extraction about 10 days before we became intimate which now raises questions and makes me very worried - what if her mouth didn't heal yet, it is easy to bleed until it heals etc.

Please help, I'm really worried! Can the sore be STD? Am I at risk of hiv if my partner is infected and could transfer during oral sex???

[Edward W Hook, MD]

I agree with the doctor that herpes is unlikely.  My avice woul be to not worry about it.  If you did have genital HSV-1 it would be very unlikely to recur.  My advice is to move forward.  If you wish to learn more about herpes you can search the topic on this site or go ASHA's excellent web site.  

This will end this thread. Take care.  EWH

[ndhlp1]

Dr. EWH,

I just wanted to provide you with a follow up as I went to see a dermatologist today about the sore on my penis. It first appeared on Tuesday last week and by Sunday it basically completely healed leaving just a small area with newly formed skin that looks somewhat like a small scar. But a couple of days ago I had another irritation on my penis - just a few pimple like irritations that looked like tiny mosquito bites that were a little scratched. They almost disappeared by today (within a couple of days).

Doctor looked at them. Said he's 95% sure that it's frictional, but leaves a possibility for herpes. He said he could do a blood test but it would most likely show as positive anyway since many people have HSV antibodies. He said even if it would be herpes - it's so common (about 60% of people have it) that it is not very serious. He said that if she had an oral herpes it could transfer during oral sex. But he said it's unlikely that my sore is herpes as "they don't dry out that quickly" he said. They also didn't hurt nor itched at all.

The doctor gave me a Cordran SP cream to use for 10 days.

I just wanted to ask for your opinion - do you agree that this is of no concern?

Thank you very much.

[ndhlp1]

Thank you very much for your help and thorough explanation, Dr. EWH! I feel relieved now and I will make an appointment with a dermatologist to exam the sore if it doesn't disappear in a few days.

Thank you!

[Edward W Hook, MD]

This is helpful.  While a direct exam may be more conclusive as I suggested above, I suspect that the area of soreness you noticed was a result of either your recent masturbation or friction during recent atheletic activities.  EWH

[ndhlp1]

Dr. EWH,

Thank you very much for such a quick and detailed answer - I appreciate it very much.

I feel so much more relieved now especially that there's no evidence of something more serious like HIV passed through oral sex (I guess even if her gums weren't fully healed yet after the oral surgery because if that would be the case we'd know about many more cases of infection through oral sex???).

Below are the answers to your questions:

- Last time I receive oral sex was on Friday night (04/01/11).
- I also had protected sexual intercourse with condom that same night.
- Prior to that I had protected sex with a condom on about 03/27/11
- Last time I masturbated on Sunday night (04/03/11)

Same day on Sunday I participated in extensive sporting activities (maybe it's just irritation caused by friction during running etc???)

I hope this provides enough information to you to form a more conclusive opinion about my problem.

Thank you so much for your reply once again, Dr. EWH!

[Edward W Hook, MD]

Welcome to our Forum.  I'l try to help and make a few suggestions but for a more complete answer you may wish to be seen by a trained clinician who can take a full history and examine both the lesion you describe and evaluate you to see if indeed do have swollen lymph nodes.  

My sense however is that syphilis is very unlikely.  Reading your thread it appears that you are heterosexual.  Further, it appears that your only unprotected sexual encounter was receipt of oral sex.  Heterosexually acquired syphilis form oral sex is incredibly rare in North America and it is unlikely that is what is going on.

The discomfort you felt in the shower is an indication that the lesion you then noticed was relatively recently acquired, still open and therefore irritated by the soap which came into contact with it.  Answers to a few questions will be helpful.  when was the last time you received oral sex?  When was the last time you had sex? When was the last time you masturbated or received masturbation.  

I also suspect that the discomfort you describe in your neck is unrelated to your sexual activity.

Finally, HIV is not acquired through oral sex.  The quoted figure for HIV risk, if one has oral sex with an infected partner is less than 1 in 10,000 and, in my estimation that is too high. Some experts state there is no risk at all from oral sex.  Neither of us on this site have ever seen or reading the medical literature of a convincing instance in which HIV was passed by oral sex.  

Once I hear a little more from you about your recent activities I will have more comments but for now, my sense is that it is unlikely that this is an STD and it is almost certainly not syphilis.  EWH