accuracy of RPR test

[jgh]

Is the accuracy of the RPR test still accurate 10-14 years after suspected contraction of syphilis?  Had what I thought was an ingrown hair on my inside upper thigh.  It went away in a week or two.   Then later had a rash on the palms of both hands that I thought was a reaction to a floor cleaner.  Don't think I had that too long either, maybe less than a week.  No other symptoms that I know of.  10-14 years later had  an RPR card test in the hospital.  Do not know the results but I was in for depression for 18 days and the records do not show any treatment with penicillin so I assume it was negative.

Fast forward to today, 24 years after the RPR test. (35-40 years after suspected incident).  Have had a rash on my right torso which my doctor visually called herpes.  Could be shingles.  No blisters just a rash. (P.S.-Have been married and monogamous for 27 years.)  The rash itches and lasts for about four weeks at a time.   Over the past three years the rash has gotten to be less.  Also,starting ten years ago I have had spastic colin for a couple of years, hives for two years, tinnitus, hemorhoids,  aching knees (probably all old age).   Anyway---should I be concerned and get another RPR test?  Would it actually be correct after all these years if it was negative?  

Sure would like an answer since this is worrying me some.  Boy--sometimes the mistakes of the past do haunt you.

Thanks.

[H. Hunter Handsfield, M.D.]

If you weren't told of a positve result 24 years ago, you can be reasonably certain the RPR was negative; it would be awfully unusual to diagnose or treat someone for syphilis and then forget to tell him; and equally unusual for the patient to forget.

Your rash doesn't suggest syphilis, and indeed a blistering rash located to one side of the chest sounds like herpes zoster (shingles).   Your other symptoms don't hint at syphilis either.  So I see no reason to re-test you for syphilis.  But it's no big deal, just a simple blood test (and cheap), so there's no reason not to do it if you would sleep better knowing the result is negative.  Ask your doc about it.

Best wishes--  HHH, MD

[jgh]

So an RPR test is 100% accurate for the life of the individual?   I thought I read somewhere that it is only 100% accurate in the middle stages.  That was my main concern.  Would prefer to get the test done anonymously for now.

jgh

[jgh]

Also, my rash is NOT blisters.   It is just red itchy pimples in the area of the right torso.  It comes and goes. Thanks. jgh

[H. Hunter Handsfield, M.D.]

Except for the first few weeks after initial infeciton, a negative RPR is always definitive evidence against active syphilis.  Also, in my response above, I forgot to add that syphilis causes rash only in the secondary stage, which occurs within a year of acqquiring the infection; rarely up to 4 years, never longer than that.

So whatever you have isn't syphilis or any STD, and that's where my advice ends.  I won't have any additional comments or advice.  Best wishes--

[Tommy420]

When is an RPR test recommended after an encounter? When is it conclusive? 4 weeks? 6 weeks? 13 weeks?

[H. Hunter Handsfield, M.D.]

RPR tesing is not recommended after any particular encounter, except if the partner is known for sure to have syphilis, or if the exposed person develops symptoms that suggest syphilis.  RPR usually becomes positive after 4-8 weeks.  

[jgh]

Thanks much.   You have answered my question.   jjgh