Sexually Transmitted Diseases/Spot under foreskin

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Spot on foreskin
Spot on foreskin  
Hi Mark, worried patient here!

5 weeks ago i had sex with a lady who i dont know that well. Penetrative vaginal sex was protected using a condom but oral (me receiving) was not protected the day after i noticed flat red spots and panicked, so i used canesten thrush cream and it seemed to clear up within two weeks. 8 days after the encounter i did the sensible thing of going to a sexual health clinic where i tested negative for Gonoreah and also chlamydia... I was happy with this so i started to have safe sex with my gf again however 5 weeks down the line i have got a coldsore on my bottom right corner of lip but not actually touching my lip and after sex with my gf i noticed a weird red spot under foreskin near the blood vessels, im extremely worried that i have caught genital and or oral herpes off this lady? The coldsore at first i thought was a spot as it was raised and i squeezed it and scratched it, it is now sore and more cold sore like, i remember having a coldsore maybe 10 years ago but nothing since! Im not sure what to do now? I have booked in to docs on monday and also sex health clinic to hopefully test for herpes but im concerned that they cant tell the difference between oral and genital? I want to get back to normal and have unprotected sex with my longtime gf but im so worried i have something

Please reply as soon as you can with any advice

Thanks

Dave aged 24 England

Answer
Hello Dave,
Herpes looks the same on the mouth or lip and the penis/genitals. It can be missed, but the photograph does not look like herpes. Coldsores are another name for herpes of the mouth.

You've used an antifungal cream without benefit, and you already tested negative for gonorrhea and chlamydia.

Do not squeeze or scratch these areas, as that in itself can cause more skin problems.

Follow through with the clinic, and be reassured as to what they tell you.

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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