Sexually Transmitted Diseases/Std?

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QUESTION: Hi, I've had unprotected sex about 14 days ago and am just noticing this rash like bumps on my penile shaft. Could this be herpes? I am very concerned about this.

ANSWER: Hello James,
The photo shows only very lightly colored areas that might be the beginning of "something." Not sure what that "something" may be, but herpes usually progresses fairly quickly over the course of several days.   In a day or so, if the areas have turned into severely irritated (numb, itchy, and/or painful) and blistered areas, than it is almost certainly herpes. If not, it isn't.  Prescribed medications may cut the length of time and viral shedding to about 5 days, but everything eventually heals even without medications.

Good luck!
--mark



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QUESTION: Hi Mark, I went and saw a doctor today and he doesn't think it's genital herpes. He gave me a cream for yeast infection but I'm still concerned about it. It hasn't caused any pain or discomfort and blisters haven't formed as of now, I am worried about the small white bumps above the rash area though. I have attatched an updated picture. Also I attatched a picture of my mouth are the white bumps at the top of it normal? Thanks

ANSWER: Hi Again, James,
The skin of your penis does not look like herpes, and as I mentioned previously, herpes rapidly progresses to something very typical and unique for the virus. The right side of the throat in the image is very red and irritated, which is common for a viral infection.  The photo does not easily visualize white spots that you speak of.  However if the sore throat is accompanied by fever, than that increases the chance that it could be due to Strep, which usually requires antibiotic treatment.

Good luck! Hope the cream takes care of the rash!
--mark

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QUESTION: Thanks for all the help Mark. I've attatched an updated picture, still no pain or tingling but from doing research online it looks to me like herpes. I know I may be wrong I'm just looking for some reassurance, and please give me an honest answer. The white spots that are approx 1mm in diameter look like they have fluid in them. The red area near the top is red as I tried to pop the fluid out. If you don't think it's herpes what do you think it is? Thanks.

Answer
Hi Again, James,
It may look like herpes to an inexperienced eye, but it does not look like herpes to me! Just to be clear, I am considering the photo of your penis, not the one of your throat. Fluid filled tiny bumps are frequently associated with a usually benign but nuisance condition known as "dyshidrotic eczema" when it occurs on the hands or feet, usually after exposure to something, like a contact irritant. Although the mechanism of the disorder is not well understood, some frequent causes include contact irritants which may be cosmetics or lubricants, constant exposure to friction with moisture from water or sweat, or repeated scratching or rubbing. Sometimes, oil or sweat glands become plugged. Sometimes skin fungi may cause the itching, that if unchecked, can result in unrelentless itching, which may look like the type of rash that you have.

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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