Penis to penis touching and sore on gland covered by foreskin

[wcguy]

Asian man, paraplegic, and uncircumcised. Intermittent catheterize myself every 4-5 hours. I have not had sex in 9 months except for one recent encounter from a male escort (24yo white, claims STD free with last STD panel done in Dec 2011, shows no sores, or had no outbreaks). We kissed while both being naked on our sides for 20 mins. He rolled on top of me. His weight was not fully on me and our genitals may have touched, not sure. I was not erect and he was. We kissed like this for about 5 mins. I sucked his penis for 5-8 minutes. I also rimmed his anus briefly for about 1 minute. I didn’t noticed any sores or bumps on his genital/anus area. I started to finger him, but I started to get scared and stopped. He came on his stomach. I didn’t come in contact with his semen. The only bumps I noticed were on his back shoulders. It had crusted over and reddish. I felt them when I ran my hands over his back. I got up and washed my hands with soap and water. Shortly after, I catheterized and applied hand sanitizer on my hands and some on my penis.
Exactly 48 hours after, I noticed an irregular shaped sore/legion on my penis head as if the skin had been torn off. The sore is not round, more like the outline of a bird's head and beak. It's roughly the surface area of a dime or nickel. This sore is covered under my foreskin. I do not have any fever or body aches. I cannot tell if there are pain with urinating, itching, or abdominal pains due to my spinal cord injury. I did not noticed this catheterizing 4 hours earlier. I don't always pull my foreskin back when I do catheterize, so I may have missed it.
Did I get herpes when he was on top of me? My foreskin does not cover my whole gland. It covers only half way up, but when I'm lying down, the foreskin may pull back enough to expose the head entirely. Do you think this sore on my gland is herpes? My lack of sensation makes it difficult to say if I have any pains. I was unaware of any blisters/vesicles before I saw this sore.

[Terri Warren, RN, Adult Nurse Practitioner]

4 months.  And yes, very low.

Terri

[wcguy]

It's been a month since my encounter. Do you mean 4 weeks or months? If 4 months, then I have 3 more to go.

Given the nature of my encounter and the description of my sore. In your experiences and expertise, you would say my chances are low still?

[Terri Warren, RN, Adult Nurse Practitioner]

A herpes lesion can be appear as a single large lesion and you are correct that in moist areas like labia and under the foreskin, the blister stage is often not noticed.  However, it still doesn't sound like herpes to me.  But in order to be certain, you would need to be tested 4 months from the encounter.  If my dates are correct, you are almost there.

Terri

[wcguy]

I have read that herpes sore in wet areas, such as under the foreskin can go straight to legion without blister. My sore initially was non-round shape
exposed area of gland. The edges from skin to expose tissue wear very clean, non crater like. After 4-5 days after raw tissue was expose, did catering appeared.

1. Can a herpes sore on the penis gland leave the unaffected tissue below unaffected such as mine was initially?
2. Can a herpes sore/legion be this big, not round, and singular? It did not seem like a cluster of small sore that form this.

Thank you so much for you insight Terri! I was/am so worried!

[Terri Warren, RN, Adult Nurse Practitioner]

Your symptoms do not sound like herpes to me.  Yes, herpes can show up in two days, but that is unusual, and I don't think I would describe herpes as skin peeling off.  I have seen what you are describing, at least I think we are on the same page, and it is most often bacterial or fungal.  I think you are on the right track with your treatment.  It takes a while for things in uncircumsized me to heal, unfortunetly.

[wcguy]

Can a sore/legion this big happen in 48 hours of a herpes initial OB? I swear, when I saw this sore, there was no cratering. It just looked like skin was torn off the gland. The gland underneath looked perfectly unaffected. Since, there is no skin on it, it started to get reddish a few days after and producing some fluids as I described above.

[wcguy]

Thanks for the prompt reply. I have had only 3 sexual partners total including this one. One was of 14 years and do not believe had herpes. Never saw any OB or sores on him. Had another encounter last year of a similar nature. Tested for HIV also 4 months after that encounter and was negative. Due to my spinal cord injury, I do not get erections consistently and so do not insert my penis in anything. I'm sure I have had balanitis before due to traveling and could not catheterize. This had happened when I would be wet from pee and wore undergarment. But in this case, I wasn't wet. I wrote more details on the community section but this forum only allowed 2000 characters, so I had to condense my post. 2 days before my encounter, I sat in the jacuzzi for more than 2 hours at 98F, much too longer than I have ever. On same day of encounter, I had started taking Bactrim DS for a UTI (staph). 48 hours after my encounter, I noticed this sore. 2 days after noticing the sore, went to go see my GP. He said it was balanitis. He said it does not look like herpes. Since I was worried it was an STD, he gave me a shot and 7 days of Doxycycline Hyclate 100mg because of my worries. He also gave me Clotrimazole-Betamethasone cream 15gm to apply on the sore in case it's yeast. He also order blood work for syphallis, gonorrhea, and chlamydia. He did not for herpes. He also did not take a swab of the the sore. I did not follow through with the lab because I wanted to finish my antibiotics first.
12 Days later - The sore shows signs of healing but very slow. There seems to be new skin growing back from around the edges. The sore is still relatively similar in size though. The anti-fungal cream seems to make the liquid (slightly yellowish) thicker with consistency like snot. Without the cream the liquid from the sore is thinner. I went back to my GP. He gave me 3 tablets of Fluconazole 150mg, which I took for 3 days.
4 Days later - After finishing all my antibiotics and anti-fungals, I went to the lab for the cultures. I am currently waiting for the results, however, I will not know about herpes. The sore is definitely healing, but very slow still. I sleep on my back and tape the foreskin back to air it out. During the day when I can't tape it back, so It gets moist and the sore is still producing liquids that are light yellow in color with a very slight odor. I should get lab results tomorrow.

[Terri Warren, RN, Adult Nurse Practitioner]

I reread your note a few time.  There is nothing in your post that makes me concerned that you acquired herpes in this situation.  However, your penis lesion would concern anyone.  Have you ever been tested for STDs in the past or this is your first sexual encounter?  Would it be possible for a clinician to  have a look at this lesion?

It leaves me puzzled, honestly.  Have you ever had anything like this before?  Have you had any difficult with bacterial or fungal infections under your foreskin before?  

I think you are writing to me specifically about herpes concerns, and this encounter.  I believe I can reassure you that this is extremely unlikely.

Terri