Sexually Transmitted Diseases/red spots

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red welts
red welts  
QUESTION: Hi Mark.  I had unprotected sex with a female twice a day for 8 days straight and these symptoms appeared 2 days after our last encounter (I see her 3 times a year, she lives outside of the country).  We are monagmous and have been for several years.

At first I felt a sensitive area at the base of the shaft like from a rug burn.  I'm fairly sure the skin was irritated from not enough lube.  There was one area that was particularly red and I started messing with it noticed a small scab dot.  Then I got paranoid and started messing with another area and started pinching every strange thing I saw, resulting in what looks like 3 welts or insect bites.

I have no other symptoms at all.  No fever, no discharge, and when I pinched the red areas to see if they were pimples there was a very very slight clear fluid.

Please help!

I'm 46 years old

ANSWER: Hello Keith,
The rash you have does not show very well in the photograph. It may be due to friction, or a reaction from the lubricant used, a mild contact irritation from the oil or preservatives or other constituents of the lube used.  If there is any itching, than you may have a skin mite known as scabies, which can be sexually transmitted.

It may too late to correctly identify the problem, but moist heat applications, followed by antibiotic ointment may help it heal. Try silicone based lubricants in the future. Find a free STD clinic in your area to have the routine syphilis & HIV blood tests (which I doubt you have), and gonorrhea/chlamydia urine test for screening.

Good luck!
--mark


---------- FOLLOW-UP ----------

second pic
second pic  
QUESTION: Mark thank you for your quick response!  I have attached a better picture.  Again, they started off as two medium areas of red that were raised....like an insect bite.  When I squeezed them the hole in the center appeared.  They haven't gotten better or worse, just stayed the same.  Does this look like herpes?

Answer
Hello Again, Keith,
Thanks for the much better photos. These do NOT look like herpes. They look like a localized staph infection causing a folliculitis. Moist heat applied to the area, followed by antibiotic ointment should resolve the problem. Don't squeeze the areas, as that action can drive the infection deeper into the tissues.

Good luck!
--mark  

Sexually Transmitted Diseases

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Mark P. Behar

Expertise

Almost any question or concern about gay men's health issues, sexually transmitted infections, abnormal Pap smears, anal cytology (anal "Pap smears"), etc. There is no such thing as “d/d free” or “clean” (free of infection), so why do so many of us deceive ourselves into thinking that some people are indeed totally free from a potentially infectious disease, like HIV, herpes, hepatitis, syphilis, chlamydia, warts, gonorrhea, etc., just because they say so? Clinical laboratory tests are not perfect, and having a “negative” or “nonreactive” test does not mean that a person is free from infection. Perhaps at the moment the test was taken, the person was uninfected; or, perhaps, the test wasn’t sensitive enough to detect presence of the infection. There is really no way that anyone can determine that they are truly “disease free,” and there are over a hundred of infectious conditions that can be spread without your knowing anything. Rather than trying to “pre-screen” or “serosort” a potential sex-mate with deceptive questions that are impossible to know by today’s technologies, a wiser option may be to consider everyone infected with something, and either use appropriate protective measures (“safer sex”), or accept the responsibility and consequences of possibly “catching” something from someone who’s hotter than expected (pun intended!). There is much research that supports the contention that an HIV positive person reliably taking HIV medications, and having an undetectable viral load, presents a lower risk for transmission of HIV than people who may think or say they are HIV negative, but are not. Food for thought!

Experience

Family Practice PA since 1981; Volunteer Clinician for Brady East STD (BESTD) Clinic, Milwaukee, since 1977; answered STD questions submitted to their web site. Professionally lectured at national and regional Physician Assistant and Nurse Practitioner conferences, and at national gay & lesbian health conferences on topics including HIV/AIDS, herpes, hepatitis, STDs, human papilloma virus (the cause of venereal warts), abnormal Pap smears, gay and lesbian health issues, among others.

Organizations
Co-Founder, Lesbian, Bisexual, & Gay Physician Assistant Caucus of the American Academy of Physician Assistants, Inc.; American Academy of Physician Assistants; Wisconsin Academy of Physician Assistants; National Co-Chair (2012-16), National Association of Black and White Men Together: A Gay, Multiracial Organization for All People (NABWMT)

Publications
Journal of the American Academy of Physician Assistants (JAPA) Q Visions, Quarterly Newsletter of the NABWMT

Education/Credentials
Bachelor's of Arts, 1972 (University of Wisconsin, Milwaukee, WI) Graduate Credits Experimental Psychology, 1972-75 (Tulane University, New Orleans, LA) Physician Assistant, Bachelor's of Science, 1981 (George Washington University, Washington, DC); Masters in Physician Assistant Studies, 2000 (University of Nebraska Medical Center, Omaha, NE)

Awards and Honors
Colposcopy Recognition Award (CRA), the American Association of Colposcopy and Cervical Pathology; Distinguished Fellow, Clinical Preceptor, American Academy of Physician Assistants; Fellow, Wisconsin Academy of Physician Assistants

Past/Present Clients
Brady East STD Clinic, Milwaukee, WI Milwaukee Health Services, Inc. (Martin Luther King Heritage Health Center), Dept. of Family Medicine and Early Intervention Program for HIV Infected Persons

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