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What do raised red spot on penis indicate?

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Posted on Tue, 22 Jul 2014
Question: Hi Dr., thanks for taking my question. Male here, received unprotected oral sex from a XXXXXXX XXXXXXX 30 yr old male, in St XXXXXXX city (have read that information is makes this a riskier event). 3 days after the incident I noticed a raised red spot on the tip of my penis. The skin looked dry/irritated and looked like it had a small sore in middle but was so small also just looked like an imperfection in the skin, couldn't tell. Went to a doctor 5 days after incident (2 1/2 days after noticing spot) who didn't seem concerned at all. He said it looked like a penile papule, took blood test (which makes me question his knowledge testing for antibodies 3 days after an incident), asked me to not have sex until after the blood test came back. While waiting on the results the spot stayed about the same size. The spot in the middle has developed a small sore. The red area in total is about 2-3mm, the sore in the middle is less than 1mm. It is not firm. Test results came back negative. Timeline was 3 days for red spot/papule, 10 days from incident for small sore. Now at 14 days and doesn't seem to be changing, but wondering how slow the process goes to develop chancre so it may be and just changing so slowly I just cant tell yet. My questions are 1) after a papule develops how long should it take for it to develop into chancre? 2) I understand that I should follow up in 6 weeks because of infection I may not see, but specifically for this spot on my penis now........ if it were a papule from syphilis would my body have developed antibodies within 2-3 days of having the red spot/papule appear? Thanks in advance for information!
doctor
Answered by Dr. Kakkar S. (23 minutes later)
Brief Answer:
Need more information

Detailed Answer:
Hello and welcome to healthcaremagic

I am Dr. Kakkar.

1) Incubation period of syphilis varies from 9-90 days. Usually a papule develops which breaks down to form a sore within 2-3 days.

2) VDRL, detects antibodies to syphilis and becomes positive a week after the appearance of a syphilitic sore.

This picture looks like a case of herpes genitalis.

I would like to know what was the test done for and what did it reveal?

Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Kakkar S. (23 minutes later)
I have had HSV-1 for 15 years. Still have outbreak 1-3 times a year but it has always been on shaft, have never had on head. Test was RPR, came back negative. I can't be 100% sure, but being that I am very familiar with the way my body has reacted to HSV outbreaks for the past 15 yrs I have doubted that is the reason for the sore. Thanks for answering both questions, I have a follow up/clarification to the second. Since it seems that this was a raised red area for close to a week before developing a sore, would the antibody test become positive a week after the papule or a week after the sore developed? I have ordered a blood test online and was planning on going to lab today to have them draw the blood. It was Fri XXXXXXX 20 that I noticed the red spot/papule, seemed like a sore started around 26th or 27th. So it's been 11 days since noticing the red spot and 5 days since the beginning of a sore.
doctor
Answered by Dr. Kakkar S. (32 minutes later)
Brief Answer:
Possibly herpes

Detailed Answer:
Hi.

The RPR/VDRL test becomes positive about a week after the appearance of chancre (sore).

Looking at the picture, this seems highly unlikely to be a syphilitic sore. A syphilitic sore is well defined ulcer, with clean base, non-tender and is hard/indurated on palpation.

This looks more like herpes. Shallow ulcer or erosion.

Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Kakkar S. (23 minutes later)
Thanks again. Would it be abnormal for the location of a herpes outbreak to change on the penis? I think I have been pretty typical with the outbreaks I have had. The first couple of years were more frequent and persistent, year after year they have become less frequent and noticeable. I think they are still substantial enough that I wouldn't have one go by without me noticing, but they affect me less. They have always been on the shaft though, in between where my foreskin was cut and the head. Have moved around from underside to the left side, but always have been in that same area, and never on the head. Is that abnormal for a outbreak to change location like that?
doctor
Answered by Dr. Kakkar S. (11 minutes later)
Brief Answer:
Herpes

Detailed Answer:
Hi.

Herpes virus resides in the dorsal root ganglion and from time to time travel down the nerve to give rise to a clinical episode of herpes.

The lesions can be distributed anywhere along the sensory supply of the affected nerve. Therefore it is not uncommon for the lesions to appear in a different area as long as they are within the sensory supply of the affected nerve, which in your case seems to be the dorsal nerve of the penis.

Regards
Above answer was peer-reviewed by : Dr. Vaishalee Punj
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Dr. Kakkar S.

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Practicing since :2002

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What do raised red spot on penis indicate?

Brief Answer: Need more information Detailed Answer: Hello and welcome to healthcaremagic I am Dr. Kakkar. 1) Incubation period of syphilis varies from 9-90 days. Usually a papule develops which breaks down to form a sore within 2-3 days. 2) VDRL, detects antibodies to syphilis and becomes positive a week after the appearance of a syphilitic sore. This picture looks like a case of herpes genitalis. I would like to know what was the test done for and what did it reveal? Regards