Doctor thought its secondary syphilis but I have no ulcer?



Noticed this two dots under palms skin 3 days ago, I am no sexually active, went to get a massage 5 weeks ago and now this appeared, doctor thought its secondary syphilis but I have no ulcer and havent had sex in 2 years. -ve VDRL&TPHA today, no bump in other hand or soles

Age: 22
Male
Medications: N/A

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Dr. J. Ernesto
Dr. J. Ernesto
April 1, 2018 2:51 pm

Yes this could be secondary syphilis. If during the massage you had contact with a syphilis sore. You may have developed an initial sore (ulcer) which you did not notice and which healed. The timeline fits with the development of the secondary syphilis. Testing is the right thing to do.

Original Poster
Original Poster
April 1, 2018 4:18 pm

I mentioned that the tests are negative as I tested today .. how can the test be negative while in the secondary syphilis?

Dr. J. Ernesto
Dr. J. Ernesto
April 1, 2018 6:27 pm

If you believe there may have been a probability of contact with an infected sore during massage, there is reason to believe this may be syphilis. But if both tests are negative, it is probably not syphilis. But tests are not 100% infallible. TPHA is a good treponemal test beyond the early primary stage . But FTA-ABS is often used as a second test. If you have doubts you may want to redo the tests. If not syphilis, the other explanation – the rash is a from of contact dermatitis. If so rash should resolve by itself in 3 to… Read more »

Original Poster
Original Poster
April 2, 2018 12:52 am

So is it possible to get a disease from her hands?! She was fully clothed so I guess it’s impossible for me to get syphilis, any by way the incident was in 22,feb. When should I test to be fully sure im clear from syphilis? And do you prefer the Tpha&FTA combination?

Note: Bumps are a bit itchy when I touch, I also have a history of dyshidrotic eczema

Dr.Honey
Dr.Honey
April 2, 2018 7:30 am

Hi.
From the complete explanation of your question and the follow up question it does not look like Syphilis as both your tests are negative that are commonly done as initial tests for ruling out syphilis.

So you need not to worry as the two spots can be due to something else.
Some kind of allergy, bug bite etc.

If you wish you can proceed for further tests like Fluorescent Treponemal antibody absorption (FTA-ABS) test, Microhemagglutination assay (MHA-TP) and Treponema pallidum particle agglutination assay (TPPA) tests.

Consult an Infectious medicine specialist or a Sexologist and get evaluated..

Regards.

T. Lawrence
T. Lawrence
April 2, 2018 7:34 am

It’s probably some type of dermatitis or a rash. I had those on my hands and when I went to the my primary care doctor, she game me some cream and it went away in a matter of days.

Dr. J. Ernesto
Dr. J. Ernesto
April 2, 2018 10:57 am

Syphilis is transmitted through oral, vaginal, and anal sex or with direct kissing or contact with a syphilis sore. Based on your info, you do not seem to have engaged in risky sexual behavior.

Original Poster
Original Poster
April 2, 2018 11:35 am

Thanks all for all the responses, what do you think should I get more tests? And what are the time frames of the tests I should get? I took VDRL and TPHA after 5 weeks of the massage which was a normal massage, could the tests I had taken missed an infection if it was present?

Original Poster
Original Poster
April 2, 2018 11:37 am

And last question also, I only have these bumps on my left hand .. nothing on my right hand or soles.. and a new very itchy one now appeared between them.. could this even be syphilis? Itchy when touch and bumps appear after each other? Or the secondary syphilis rash comes all at once? Thanks