Syphilis or not?

[instereo]

Ive been in a sexually active (oral, vaginal) and as far as i can tell monagomous relationship for about 3 years now. The only other sexual partner ive had was about 1-2 years before the start of this relationship. A few days ago i noticed a small red circle on the lip of the tip of my penis. It doesnt hurt at all, doesnt protrude, does not look like a pimple or zit at all and does not look like it contains puss. it more than anything looks like a circular scar with a very thin layer of dry skin on top, and seems to be healing slowly. a couple months ago i had a very tiny cut in the exact same place as this red circle is now. it seemed that it healed fine, and this circle was not present at this time. when I saw this thing i freaked out and immediatley researched on the net and found it is a similar symptom of Syphilis. I also found that penicillin is the most common treatment for syphilis.

    The odd thing is about 3-4 weeks ago (before the "sore" appeared) i had my wisdom teeth removed and i was prescribed vicadin and PENICILLIN VK...500MG pills/4 pills a day/7 days. since then i have had sex with my partner. so at this point im confused, and im really hoping you can help me out and suggest what my next course of action is.

my questions are...

1) Whats the longest amount of time that can pass before symptoms show?

2) Is it possible that the kind of penicillin i was on wouldnt have cleared up syphilis (if it is syphilis)?

3) Is it possible that my girlfriend contracted it from someone else at some point in our relationsip and simply re-infected me after my penicillin course was through?

4) Is it possible that one of us has had syphilis for the entire duration (3 years) of our relationship and not shown ANY symptoms?

5) if you dont think this is syphilis or an STD in general, what are other reasons for this kind of lesion to appear? de-hydration? irritation? scar tissue from the previous cut?

--> I do NOT have any of the other symptoms related to syphilis i.e joint paint, swollen nodes, or rash

I appreciate any info you have for me and think you do an excellent job with the advice you give.

[H. Hunter Handsfield, M.D.]

I don't know what you found online that made you think the spot you describe could be due to syphilis.  It doesn't sound like it to me.  (On the other hand, ANY skin lesion can look like syphilis sometimes.  Syphilis was once called "the great imitator" because the symptoms are so varied.)  Anyway, your risk for syphlis seems to have been zero, and indeed if you had it, the penicillin V wouid have cleared it up.  On top of all that, if that spot were due to syphilis, it would have to be the secondary stage, which always appears within 12 months of infection.  So it could not have been syphilis from your exposure more than 3 years ago.

The answers to your question are:  1) For that symptom, up to a year, no longer.  2) No.  3) Sounds unlikely.  Syphilis is rare in most heterosexual population groups in the US and other western countries.  4) No.  5) I haven't a clue what it might be.  Any of the hundreds of conditions that cause skin rash can show up on the genitals--ringworm or other fungal infection, psoriasis, eczema, dermatitis, chemical irritation, etc, etc, etc. You'll need to see a health care provider to know.

HHH, MD

[jeffinphilly]

Would a urinalysis taken show a present std?  If not, would certain things like white blood count indicate an infection, thus leading the doctor to give more tests?

[instereo]

hey thanks a lot doc, i feel a lot better.
im just wondering if the constant rubbing against my clothes could have caused that cut to heal irregularly after a length of time? its just odd, it seems the cut and the sore are connected, given they were in the exact same spot.

[H. Hunter Handsfield, M.D.]

Condoms aren't perfect because they don't prevent all skin-to-skin contact.  But consistent condom users rarely get genital herpes.  However, if you want 100% protection against HSV-2 and HPV, complete avoidance of sex is your only option.

HHH, MD