Condom break / possible syphilis

[locker_1988]

Dear all,

I am seeking your advice in connection with the following. About 6 days ago, I had a protected intercourse with a csw in Kiev, Ukraine. We used condom, but, at some point, the lady found that it failed and we got it replaced. I am not able to assess the time during which the condom was broken during the vaginal intercourse, and if it was broken at all during that process, as she found it out during the fellation following the intercourse.

I am not that concerned about the risk of HIV (low chances from a single contact + unknown status + csws seem to use condoms on a regular basis, which suggests that the chances are even lower etc), however, this morning (the 6th day following the contact) I found a small pink spot on a tip of the penis. It does not look like an open sore or something, just a very small pinhead size spot. Other than that, I am not feeling any other usual symptoms (swollen lymphs etc).

Having read the publicly available materials, I understand that the sympthoms of syphilis normally appear within 10-90 days after the exposure, with three weeks being an average period. In this case, 6 days seem to suggest that this spot could be due to something else, however, can not be 100% sure, and this makes me feel a bit uneasy.

Taking into account the above, are there grounds for concerns, or is this simply freaking out? Also, if you think testing is advisable, what is the period after which it could be done?

Thank you very much in advance!

[Edward W Hook, MD]

If you have had similar spots in the past, it is unlikely that they are related to your recent exposure.  A dermatologist would be the correct person to evaluate such lesions.  EWH

[locker_1988]

Thank you very much for replying! Thinking about this further, I recall that I could have similar spots in the past - these were just the spots, not rashes or sores. I never experienced anything like pain during urinating or other emissions.
So perhaps these spots are something that need to be referred to a dermatologist?

[Edward W Hook, MD]

Welcome to the Forum.  Congratulations on taking what appears to be a level-headed approach to your condom mishap.  While the risk of any STD following a single exposure is low, it is worth getting checked out.  The STD which is most likely to cause a genital lesion 6 days following exposure is herpes and this lesions really does not sound like that.  The average incubation time for lesion formation in syphilis is about 21 days so this is rather early for that.  My guess is that this is not an STD but if it is not too difficult, my advice would be to have a knowledgeable clinician take a look.  Inspection of the lesion and testing at this time is reasonable - tests for gonorrhea and chlamydia will be accurate and if this is syphilis or HSV the clinician, perhaps will the help of testing should be able to determine this as well.  

Hope this comment is helpful.  EWH.