Syphillis sore?

[pleasehelpme1]

Doc

On May 17th I had rigerous hand genital masterbation with another guy.  Thursday the 27th I woke up with a red looking rash on my penis.  By the 29th the rash was gone and a small red nodule appeared maybe two or three millimeters round.  I am worried this is primary syphillis.  
My sore is small and raised.  From what I have ready, primary syphillis is usually a bit larger and a crater.  Is this tru?

Please advise as for the last four days I have wondered if this could be MC, syphillis or nothing.

[Edward W Hook, MD]

The typical syphilis sore starts as a slightly raised area which, after a day or two at most becomes ulcerated ( a  crater).  Lesions are most often between 0.5 and 1.5 cm in diameter (about the size of a dime) and are painless.  EWH

[pleasehelpme1]

The earliest the local health dept could get me in is monday so i have just a few questions that I believe will be beneficial to the audience of this website.  And I say that because i've seen your earlier posts that state you have probably seen more syphilis than just about most docs in the US.

1. The sore I have is small, it is smaller than a pencil's eraser tip, is that normal for syphilis?  If not what is a more typical size?

2. What I was looking at was a red shiny spot with the center raised and brown.  Is this typical? I have read that in Primary Syphilis the chankre is usually a crater with a well defined ridge.

I will let you know what the health department says.
thanks

[pleasehelpme1]

Thanks again, I just called for an appt at the health department.

[Edward W Hook, MD]

Welcome back to the Forum.  On a statistical basis it is almost certain that this is not syphilis.  Syphilis, which is only transmitted when there is direct contact between a lesion and an uninfected skin surface, is rarely transmitted by hand to genital contact.  Syphilis itself is a rare disease with less than 10,000 cases being reported in any year for our entire country of over 350 million people and , as I said before, transmission by hand to genital contact is so rare as to be a medical curiosity.  If this was syphilis, a syphilis blood test taken at any time 4-5 days after the appearance of the lesion would be positive so getting tested in the next day or so would provide you with peace of mind if you need it.

As to what this might be, that is hard to say.  My advice is that you should have a trained professional take a look.  In most areas, the best place to seek such advice is your local STD Clinic where the staff not only have the most experience of anyone in the community at looking at genital lesions but where the care is also inexpensive and highly confidential.   In the meantime, my advice is not to squeeze or rub it, not to take antibiotics and not to put any creams or lotions which might change the appearance on it.  This will help the clinician you see to make a definitive diagnosis for you.

Hope this helps.  EWH