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What Causes Rashes On Palms And Legs When Tested Negative For Syphilis?
Posted on
Thu, 22 Oct 2015
Medically reviewed by
Ask A Doctor - 24x7 Medical Review Team
Thu, 22 Oct 2015
Answered on
Thu, 12 Nov 2015
Last reviewed on
Question : Hello doctor,
I have a question regarding syphilis and testing.
4 months ago I engaged in protected vaginal sex and received unprotected oral sex from a sex worker in Thailand.
9 weeks later I tested negative for hiv, syphilis, gonnorhea, and chlymydia.
However, a few days ago, I noticed ring-like rashes on the palms on my right hand and one or two of those "rings" on the soles of my right feet. They only seem like discoloration of the skin and do not itch and cannot be felt physically.
Out of anxiety I just received another RPR syphilis test today (4 months after) and it was negative. However, my main concern is that since the encounter, I finished a five day course of 500mg amoxicilin for my throat around 10 weeks post encounter and took another two days of amoxicilin around three weeks ago (quit because it started goving me yeast infection, diagnosed by doctor). My fear is that the amoxicilin would interfere or change the result of the RPR test that i received today. Would that be the case?
Or if the rash on my palms were really secondary syphilis, would it show up on the RPR anyway? Show I just stop worrying?
Thanks for your guidance doctor!
P.S. I attached a picture of the rash on my palms
I have a question regarding syphilis and testing.
4 months ago I engaged in protected vaginal sex and received unprotected oral sex from a sex worker in Thailand.
9 weeks later I tested negative for hiv, syphilis, gonnorhea, and chlymydia.
However, a few days ago, I noticed ring-like rashes on the palms on my right hand and one or two of those "rings" on the soles of my right feet. They only seem like discoloration of the skin and do not itch and cannot be felt physically.
Out of anxiety I just received another RPR syphilis test today (4 months after) and it was negative. However, my main concern is that since the encounter, I finished a five day course of 500mg amoxicilin for my throat around 10 weeks post encounter and took another two days of amoxicilin around three weeks ago (quit because it started goving me yeast infection, diagnosed by doctor). My fear is that the amoxicilin would interfere or change the result of the RPR test that i received today. Would that be the case?
Or if the rash on my palms were really secondary syphilis, would it show up on the RPR anyway? Show I just stop worrying?
Thanks for your guidance doctor!
P.S. I attached a picture of the rash on my palms
Brief Answer:
Very much unlikely to be due to Secondary syphilitic lesion.
Detailed Answer:
Hi,
Welcome to HCM.
Thanks for posting your query.
Amoxycillin can delay the formation of syphilitic antibodies.
But Your lesions are unlikely to be due to secondary syphilis due to the following reasons.
1. Syphilitic lesions are always bilateral. Your lesions are present only on your right side.
2. Palmo-plantar syphilides are slightly raised (hyperkeratotic papalues), not just discoloration alone.
3. You had you amoxycillin 10 weeks (70 days) after the exposure whereas you had you last test 4 months (120 days) after the exposure. Syphilitic serology normally expected to be positive by 4 weeks after the exposure. It would not be delayed so much to give a non reactive result after 4 months.
4. It is quite unusual to have secondary syphilis without any ulcer genitals (Primary stage).
5. Presence of Palmo-plantar lesions alone without any other lesions of secondary syphilitic lesions (other skin, mucus membrane lesions or conyloma lata) is rare possibility in case of a secondary syphilis.
So syphilis is quite unlikely cause for your palmoplantar lesions.
We have to look for other causes. Seek the help of a Dermato-venereologist.
Dr S.Murugan
Very much unlikely to be due to Secondary syphilitic lesion.
Detailed Answer:
Hi,
Welcome to HCM.
Thanks for posting your query.
Amoxycillin can delay the formation of syphilitic antibodies.
But Your lesions are unlikely to be due to secondary syphilis due to the following reasons.
1. Syphilitic lesions are always bilateral. Your lesions are present only on your right side.
2. Palmo-plantar syphilides are slightly raised (hyperkeratotic papalues), not just discoloration alone.
3. You had you amoxycillin 10 weeks (70 days) after the exposure whereas you had you last test 4 months (120 days) after the exposure. Syphilitic serology normally expected to be positive by 4 weeks after the exposure. It would not be delayed so much to give a non reactive result after 4 months.
4. It is quite unusual to have secondary syphilis without any ulcer genitals (Primary stage).
5. Presence of Palmo-plantar lesions alone without any other lesions of secondary syphilitic lesions (other skin, mucus membrane lesions or conyloma lata) is rare possibility in case of a secondary syphilis.
So syphilis is quite unlikely cause for your palmoplantar lesions.
We have to look for other causes. Seek the help of a Dermato-venereologist.
Dr S.Murugan
Above answer was peer-reviewed by :
Dr. Yogesh D
Thanks doctor,
So just to clarify, my blood test is reliable as I took amoxicillin 10 weeks after the exposure whereas my antibodies would already have showed up by week 4?
By taking the amox, does that make my antibodies disappear when testing? What about the 2 days of amox that I took and quit early 3 weeks ago?
Furthermore, are there any other std's that can manifest itself in rashes like this? Thanks!
So just to clarify, my blood test is reliable as I took amoxicillin 10 weeks after the exposure whereas my antibodies would already have showed up by week 4?
By taking the amox, does that make my antibodies disappear when testing? What about the 2 days of amox that I took and quit early 3 weeks ago?
Furthermore, are there any other std's that can manifest itself in rashes like this? Thanks!
Brief Answer:
Amoxycillin what you took had no effect on your test for syphilis.
Detailed Answer:
Hi,
Welcome back.
Your questions were quite reasonable.
As you said, antibodies against syphilis in the presence of an infection would take 4- 6 weeks to appear. But you had taken Cap.Amoxycillin 10 weeks after the exposure and for another two days still later. Those would not have any effect over the appearance of the antibodies. Similarly following the adequate treatment, antibodies are likely to disappear only after 3-6 months in case early syphilis whereas it would take an year to disappear in case of syphilis.
Dr S.Murugan
Amoxycillin what you took had no effect on your test for syphilis.
Detailed Answer:
Hi,
Welcome back.
Your questions were quite reasonable.
As you said, antibodies against syphilis in the presence of an infection would take 4- 6 weeks to appear. But you had taken Cap.Amoxycillin 10 weeks after the exposure and for another two days still later. Those would not have any effect over the appearance of the antibodies. Similarly following the adequate treatment, antibodies are likely to disappear only after 3-6 months in case early syphilis whereas it would take an year to disappear in case of syphilis.
Dr S.Murugan
Above answer was peer-reviewed by :
Dr. Sonia Raina
Another question/concern doctor,
I have been diagnosed with yeast infection on my penis 3 weeks ago due to overapplication of hydrocortisol and antibiotic use. Since then, I have been applying clotrimazole cream twice daily and is on my second dose of diflucan. However 3 days ago I noticed these "ring" like lesions on my penis, they do not itch or hurt... I have attached more pictures for you, do you have any idea what they are. Could any std manifest like this? Is it possibly related to the rash on my palms?
I have been diagnosed with yeast infection on my penis 3 weeks ago due to overapplication of hydrocortisol and antibiotic use. Since then, I have been applying clotrimazole cream twice daily and is on my second dose of diflucan. However 3 days ago I noticed these "ring" like lesions on my penis, they do not itch or hurt... I have attached more pictures for you, do you have any idea what they are. Could any std manifest like this? Is it possibly related to the rash on my palms?
Brief Answer:
Not related to STD. Consult a dermatologist
Detailed Answer:
Hi,
Welcome back.
I saw the picture sent by you.
Your glans penis has no sign of yeast infection at present. In one picture it reveals that you are having pearly penile papules which has no clinical importance and can be ignored. There is no sign of inflammation or infection as there is no redness over penis or surround the ring like lesion.
Your lesion is not related to any STD. It could be a non infectious and non STD skin condition.
Rare possibility of circinate balanitis in Reiter's disease (can have palmar lesion also). But it is also not so typical.
A Dermato-venereologiston close inspection and examination can able to help you better instead of guessing from a picture.
Dr S.Murugan
Not related to STD. Consult a dermatologist
Detailed Answer:
Hi,
Welcome back.
I saw the picture sent by you.
Your glans penis has no sign of yeast infection at present. In one picture it reveals that you are having pearly penile papules which has no clinical importance and can be ignored. There is no sign of inflammation or infection as there is no redness over penis or surround the ring like lesion.
Your lesion is not related to any STD. It could be a non infectious and non STD skin condition.
Rare possibility of circinate balanitis in Reiter's disease (can have palmar lesion also). But it is also not so typical.
A Dermato-venereologiston close inspection and examination can able to help you better instead of guessing from a picture.
Dr S.Murugan
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Doctor,
I just saw a general practitioner regarding my rash on the hand and lesion on penis. She told me to simply ignore the penis lesion and told me that the rash on my hand looks like an allergic reaction (histamines). My question is should the lesion on the penis be ignored given if it doesnt develop into anything more? And can histamine rash on hand last a few days like this?
I just saw a general practitioner regarding my rash on the hand and lesion on penis. She told me to simply ignore the penis lesion and told me that the rash on my hand looks like an allergic reaction (histamines). My question is should the lesion on the penis be ignored given if it doesnt develop into anything more? And can histamine rash on hand last a few days like this?
Brief Answer:
Direct examination by a Dermatovenereologist will be more appropriate.
Detailed Answer:
Hi,
Welcome back.
General practitioner is not a very competent person to give opinion for your lesions over penis and hand. Even between two experts in the field of Dermatology and Venereologist will have different opinion about these lesions.
Penile lesions can sometimes be ignored. But only a direct examination can assure the same.
Regarding the palmar lesion also urticarial rashes (erythema) or a contact with some allergen are possible. But examination in person is of more value than giving the opinion by seeing the picture.
Dr S.Murugan
Direct examination by a Dermatovenereologist will be more appropriate.
Detailed Answer:
Hi,
Welcome back.
General practitioner is not a very competent person to give opinion for your lesions over penis and hand. Even between two experts in the field of Dermatology and Venereologist will have different opinion about these lesions.
Penile lesions can sometimes be ignored. But only a direct examination can assure the same.
Regarding the palmar lesion also urticarial rashes (erythema) or a contact with some allergen are possible. But examination in person is of more value than giving the opinion by seeing the picture.
Dr S.Murugan
Note: Consult a Sexual Diseases Specialist online for further follow up- Click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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