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Dr. S. Attili
Dr. S. Attili, Dermatologist & Dermatopathologist
Category: Dermatology
Satisfied Customers: 4614
Experience:  MRCP (Dermatology), Int. Board Certification in Dermatopathology
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A stripper had on a thong. she pulled out my penis with my

Customer Question

A stripper had on a thong. she pulled out my penis with my elastic waste band over the bottom of the shaft. Scortum was in my underwear. she put ky and a condom on my penis. she rubbed it with her hand, breasts, and outside of her thong. there could be a space between the condom and the elastic waste band that could have been bare skin not sure. what is the risk for std mostly herpes and warts
Submitted: 2 years ago.
Category: Dermatology
Expert:  Dr. S. Attili replied 2 years ago.
Hi. I will do my best to advise. However, please note that this does not substitute an in-person consultation with a doctor.

I had answered your question earlier this morning. Did you see my answer?

Expert:  Dr. S. Attili replied 2 years ago.
Hi. I will do my best to advise. However, please note that this does not substitute an in-person consultation with a doctor.

I had answered your question earlier this morning. Did you see my answer?
Customer: replied 2 years ago.
I did see the answer did you have some other questions? I think it may be in my head I feel some burning on the right side of penis and scrotum it is not red and no bumps. It has been 2 days since the incident. I also feel the burning where my thighs rub together feels like dry skin. is there anything I can do to be sure. the burning are is where the elastic waistband was at. I cant sleep and am worried.
Expert:  Dr. S. Attili replied 2 years ago.
It is strange because the question I answered this morning was closed by customer service. Did you request a refund?

I think all your symptoms are just due to anxiety rather than anything else. If you have dry skin, just use a moisturiser regularly. You do not have a rash and it is extremely unlikely that any if your symptoms are due to an STD. But if you have further questions or anything changes, just reply back to me.

Customer: replied 2 years ago.
how long does it take for any symptoms to show for most people.
Expert:  Dr. S. Attili replied 2 years ago.
Most STD's usually 2-3 weeks. But HIV can take years.
Customer: replied 2 years ago.

i saw info online saying herpes shows up in 2-7 days is this normal? would I notice it only where contact could have been? would it travel anywhere else?


I saw your answer and it seems unlikely for any std. not worried about any that need penetration like hiv.


how far away from the vagina do herpes sores form is it possible to have any out of the thong. is the chance for herpes higher during penetrating sex and would the penis have to touch the vagina to have any transmission?

Expert:  replied 2 years ago.
Herpes can develop in 2-7 days but can take upto 3 weeks.it come come up anywhere within the boxer shorts area.

You just need skin to skin contact in the boxer shorts area. Don't need vaginal contact. However unless there were active sores on her the chance of you getting it, is extremely low
Dr. S. Attili, Dermatologist & Dermatopathologist
Category: Dermatology
Satisfied Customers: 4614
Experience: MRCP (Dermatology), Int. Board Certification in Dermatopathology
Dr. S. Attili and other Dermatology Specialists are ready to help you
Customer: replied 2 years ago.

if there was a sore it was dark and I could not see. what are the chances of contracting any of these? i read they can be contracted even without a sore. do you have a percentage of chance?

Expert:  Dr. S. Attili replied 2 years ago.
A percentage even if I give you would be meaningless. But without a sore, I would say less than 1%
Customer: replied 2 years ago.

i am circumsized. where the foreskin ring is has had a burning sensation on the right side of my penis since the next day after the event. It seems to be getting worse I think. no blisters i have been watching it and checking it about every hour. I will stetch out the skin to see if there are any blisters. slight redness now. my penis curves to the left and this side lays against my underware. I feel fine other than being tired and stomach a little upset from worry. I have worried about things before and it feels the same. I put neosporin on it to help with moisturization. does a burning sensation on the side of the shaft mean anything? No burning when I pee, tip of penis is normal, all other areas of irritation have gone away. where my thighs rub together are not red but feel dry not to touch but irritation. is there anything that this could be? or is this the onset of herpes. I noticed a little red hole like a hair folicle. I do not have hair this high I assume there are pores. would it hurt to touch it? would it feel numb like a cold sore? how small can the blister be? would there only be 1 tiny blister? would a herpes blister be big, or the size of the end of a stick pin or skin pore hole?

Expert:  Dr. S. Attili replied 2 years ago.
I desk with at least one customer every day with exactly similar anxiety symptoms as yours. Your symptoms are not unique and very common in someone who is worried.

None of your symptoms are indicative of anything serious. As I said earlier, the best option for you is to get a std screen done and that would solve all your anxiety issues.
Customer: replied 2 years ago.

how soon can i get the screening done? can they look at my sore area?


I put neosporin on it overnight and it is feeling better still no large blisters looks like regular bumps unless microscopic blisters.

Expert:  Dr. S. Attili replied 2 years ago.
You can get the screening done straight away but have to repeat it again in 6 weeks. Yes they can look.

I think the neosporin is just acting as a moisturiser. But it is good if your symptoms are getting better. As i said, i think it is all due to anxiety
Customer: replied 2 years ago.
still no blisters not really much redder than the other side pain comes and goes. other areas that felt funny do not feel that way anymore. I was reading you cant get an accurate hsv2 check for 3 weeks, is this correct I did read about a swab test. do most people braek out with blisters that encounter this?
Expert:  Dr. S. Attili replied 2 years ago.
Yes only if you have blisters is it possible to diagnose herpes with a skin swab and in the absence of any blisters, you do not have herpes. An STD screen also includes a blood test for herpes and that can pick up active infection even though a swab cannot, when there are no blisters. So I would suggest getting it done for your peace of mind, even though there are no suggestive symptoms. All your symptoms so far can just be attributed to anxiety.

Customer: replied 2 years ago.
okay we are on day 9 i have been to the doctor for the spots I talked about they were burning, red, and had little bumps. the doctor said it is not herpes because there are no blisters. the steroid cream he gave me made the 2 rash spots go away and not burn in about 4 days. but in the middle of this I got a rash spot on the right side towards the tip of my penis. it had red bumps. I got nervous and saw the doctor again. he looked close and said no blisters it can not be herpes. He said something has irritated it and I am not sure what but I can tell you it is not herpes or warts. All I read online says herpes can infect people and they don't even notice it because it is suttle. the doctor says you will notice it. it will have blisters, and you will have other symptoms. can anxiety actually cause a rash. did I get into something to cause the rash. is this early onset of herpes. the cream seams to be working. Just looking for a second opinion because I am reading all sorts of different opinions on the internet.
Expert:  Dr. S. Attili replied 2 years ago.
I would tend to agree with your doctor. I did not see any evidence of herpes and if there are no water filled blisters it cannot be herpes. You are right that herpes infection can be 'silent', but its an all or none phenomenon. If it is silent, you would not see 'anything'. You won't just see tiny non-specific bumps.

I hope that makes sense.
Customer: replied 2 years ago.
I read herpes can be silent, but my doctor told me if you have not had hsv2 and it was your first exposure it will show up in 2 - 7 days and will form blisters. no questions about this. i thought these conditions were different in everybody but he was pretty confident. but then he askd the questions "the condom was on the whole time correct?" this made me worry because even though I was not drinking I could not remember if she rubbed her panties against it first before she put the condom on. the steroid cream is clearing it up but I am at day 10 and these started day 4. got the cream on day 5 the sides mostly cleared by day 6 a little burning then on day 6 it broke out on the tip and made the skin stick up in red bumps. I even tried to pop one but it would not it just hurt. it is now day 10 and the rash on tip is almost gone. does not hurt near as much. hopefully it will be gone by tomorrow. the doctor gave me xanax to sleep at night which has helped my worry and tiredness. The only worry I still have is the internet articles read that it can take up to 20 days for signs of herpes to show. my doctor said that is not true on the first infection. also read you may have it and not know. my doctor also said this is not true. I am getting conflicting answers from online information. you, my doctor, and a medhelp board all agree that there was not much risk and you have to have blisters to have herpes, and it will show up in the first week. is this true or can it be sitting dormant. from what I understand as the virus enters the skin it will stay at the surface and cause the sores and blisters before it goes into the nervus system. with no antibodies to the virus it will explode on the first time. so how can it enter and sit dormant. also is it possible I still have it? also what do you think this is? could it be anything else serious. Again never have had problem with urination no burning. I have not been sick other than the worried sick but I have had that before and know what that feels like.
Expert:  Dr. S. Attili replied 2 years ago.
I am not sure what will reassure you as you do seem to be very anxious.

I can only repeat what I have already said earlier. Your risk of an STD is very low, given that you had a condom on for whatever length of time.

Yes herpes can show up at any point, and you could get it a few weeks down the line. But there is no point worrying about it as you used protection and the risk is very low. What I can tell you is that the current rash, does not sound like herpes.

If you want to be absolutely sure, get the herpes IgG and IgM tests done now and once again in 3 weeks.

Customer: replied 2 years ago.
my doctor said that a herpes test will show up positive because I get cold sores. and from what i read the tests do not distiguish between hsv1 and hsv2 or do they and how accurate are they. since they test for antibodies and I have not had an outbreak would there be any present
Expert:  Dr. S. Attili replied 2 years ago.
no hsv1 and hsv2 blood tests are completely different. If the IgM is high then it indicates recent infection. If the IgG is high, it indicates past infection. So that will solve your anxiety as the blood tests will pick up silent infections too.
Customer: replied 2 years ago.
i had a cold sore on the sunday of the incident so would that scew the test. so there is no test that can tell the difference between hsv1 and hsv2 is that correct?
Expert:  Dr. S. Attili replied 2 years ago.
incorrect. Please see my reply above.
'no hsv1 and hsv2 blood tests are completely different.' The difference can be easily made out.

Customer: replied 2 years ago.
who does these tests
Expert:  Dr. S. Attili replied 2 years ago.
any local immunology/ virology lab should do them. Your GP would know
Customer: replied 2 years ago.
do these show false negatives and positives or are they pretty accurate
Expert:  Dr. S. Attili replied 2 years ago.
They need to be interpreted properly but in general they are pretty accurate
Customer: replied 2 years ago.

here is the informatin I revcieved from the test center


HSV 1 & 2 – IgG


HSV 1 & 2 – IgG is the preferred test for uncovering Herpes. The herpes simplex virus gives off antibodies that this test detects. The test can determine what kind of herpes simplex virus you have, but cannot state definitively where the infection has manifested on the body. Should you be asymptomatic, the length the virus has been present in the body cannot be determined.


HSV Types 1 & 2 – IgM


The HSV Types 1 & 2 – IgM test does not inform you which type of herpes simplex virus you’ve got. But it can detect the antibodies produced shortly after initial HSV contact. These antibodies show up about seven days right after contracting the virus.


 


so it sounds like because I had a cold sore on my mouth just before this incident the igm may indicate a recent infection but will not show what kind 1 or 2.


also the iGG is it too soon for anything to show 10 days later

Expert:  Dr. S. Attili replied 2 years ago.
I think your lab might not have all the facilities. IgM for HSV 1&2 can be done independently. Maybe you need to find another lab.
Customer: replied 2 years ago.

I still have a faight red rash that burns when it touches my underwear on the tip of my penis. it has been around since 5-6 days after the event. the 2 spots on the side went away with the steriod cream. I went and say the dermatologist PA this week and she mentioned maybe it is syphillis. this scared me She went and asked another doctor and came back and said we do not need to test. the rash has no blisters, no pus, no open sores, no scabbing, hurts when touched, no burning during urination. what do you think this is and why is it not going away the pa gave me hydrocortizone 2.5% and said only use twice a day. she thought the other steriod cream may be too harsh. how can I make this go away faster and does this a possible sign for any other std

Expert:  Dr. S. Attili replied 2 years ago.
Do the steroid creams usually clear it up?
Customer: replied 2 years ago.
This is the first time I ever had it it started 5-6 days after event. Rash still here it looks like it may be getting a little better. The dermatologist pa gave me hydrocortizone 2.5 instead of another steroids cream she said was harsher and I would use the other cream 4-5 times a say
Expert:  Dr. S. Attili replied 2 years ago.
Ok. No this does not sound like syphilis. Its more likely to be an eczema. If it is getting better, I see no reason to worry.

Customer: replied 2 years ago.
Why do you think not syphillis does it always form an ulcer i read it heals on its own but in what time period. Also it has been over 4 weeks Di std sores last this long again it is red no scab crust or ooze just raised skin. How long does exzema take to heal it has been over 4 weeks. Will this ever heal is it better to put vasoline on or leave it along does over applying steriod and or hytocordizone cream cause more damage. Is there another solution to try
Expert:  Dr. S. Attili replied 2 years ago.
Yes. Syphilis in the first stage always forms an ulcer.

It doesn't sound like an STD. Would it be visible on a photo.

With proper treatment, eczema responds in 2-3 weeks. I would usually suggest a strong steroid like betamethasone as cortisone in my experience is not so effective. However you can try it and see. I would suggest using Vaseline in between times 3-4 times a day, rather than using it along with the steroid cream.

Customer: replied 2 years ago.
I was using a steriod cream memosante not sure name is XXXXX XXXXX said since it had been over 3 weeks to switch to something not as harsh. I told her I tried a and d for a few days between steriod apps because I found out it can thin skin. I have read posts from others that never get rid of the rash. Also should I wrap gauze around it to keep it from. Rubbing. I can send pic but how do I get it attached. I am on week 4 anything that will speed this up
Expert:  Dr. S. Attili replied 2 years ago.
You have three options for sending me pictures:  

1. The quickest:  upload the pictures here using the paperclip like icon in your chat box.  You can't find it if you are browsing via a mobile/ipad or a non-internet explorer browser like google chrome etc. You can try uploading via Internet explorer browser if you can. iPad/mobile users can email it to your our email id, download it to your laptop if you have one and then upload via Internet explorer. 

2. Upload the pictures to online photo sharing websites like Flickr/photobox/picasa web albums and paste the link here. 

3. Alternatively you can send them by email toXXX@XXXXXX.XXX with the subject line 'FAO dermatology expert Dr. Sasi Attili'.  Please note that you HAVE to send them from the email address you registered with on justanswer OR paste the link to your question in your email, or else the email won't be forwarded to me. Also do note though that emails might take up to 24 hours to be forwarded to me (and hence first two options preferable), though usually they are forwarded within a few hours. 

I shall get back once I receive the photos. Hope to hear from you soon.
Customer: replied 2 years ago.

Expert:  Dr. S. Attili replied 2 years ago.
I can see a bit of redness around the urethra opening. Is this area itchy/ sore?

Customer: replied 2 years ago.

it is irritated when it rubs against my pants otherwise no. if it is just sitting out no pain or itching. If you see to the right side of the urethra opening there are raised red areas. that is what gets irritated. in the morning it is less red and latter becomes a little more red.

Expert:  Dr. S. Attili replied 2 years ago.
To me it looks nothing more than irritated skin on the glans. I can't see any evidence of any STD. If it is not bothering you, I suggest you leave it alone. Sometimes we make a mountain out of a mole hill, because we are anxious. The redness there I would say is insignificant and infact if it is not itchy/ sore, is probably within normal limits.
Customer: replied 2 years ago.

I cant let it hang in my underware because it irritates it and then hurts. I have to pull my underwear tight and then it is better. after a lot of walking it hurts some. if I sit for a while it is better but it has been 4 and 1/2 weeks.


the first medicine was mometasone furoate cream 1% that is what the dermatologist pa though may be irritating it. I was putting it on 3-4 times a day to make it feel better. I think it is lightening up a bit from when this first started but I had no pics then so nothing to compare to.

Expert:  Dr. S. Attili replied 2 years ago.
ok. 3-4 times a day is a bit too much. Why don't you use it (or hydrocortisone) just once a day and also use it along with clotrimazole cream twice a day(to cover for any possible yeast infection), for 3 weeks. Most eczematous problems on the penis, should clear up with this regime.
Customer: replied 2 years ago.

what you put vasoline on it in between times or just let it breathe.


does it look like a yeast infection? and what do those feel like?


also why would the dermatologist pa have thought syphillis and then when she talked to someone else changed her mind. is there something I am missing?

Expert:  Dr. S. Attili replied 2 years ago.

Yeast infections can present in various ways and any eczematous area on the penis, needs to be treated for yeast infections as well. This can present with exactly the same symptoms as you have. I really don't know why your dermatologist thought you had syphilis!!

 

Yes, you should still put on vaseline in between times.

Customer: replied 2 years ago.
Is miconazole the same as clotrimazole
Expert:  Dr. S. Attili replied 2 years ago.
No. But both work similarly. So, should be fine.

Customer: replied 2 years ago.
If it is a yeast infection wouldn't it have spread in 4.5 weeks.
Also why do you think this is hanging around so long
Expert:  Dr. S. Attili replied 2 years ago.
I don't think it is a yeast infection for sure. I just said that it is best to treat for a yeast infection as it often complicates eczema on the penis.

Skin rashes behave differently in different people and it is difficult to say why some people have them for longer periods
Customer: replied 2 years ago.

will there be other signs to look for to see if it is exzema?


Do any std rashes stick around for this long with no blood, ooze, or crust?


I read that if it is bacterial the antifungal can make it worse. is a bacterial infection common in this area and what does it look like? do you see in the last picture how the red marks run front to back in a line? it looks like the normal ridges and curves of the skin but can those lines be scabies? I am not sure what they look like or how they react.


this is the longest something has taken to heal that wasnt a bone so I am confused on what to look for and it is hard to see any progress at this pace.

Expert:  Dr. S. Attili replied 2 years ago.
The creams wouldn't make bacterial infections worse and bacterial infections do not occur on the penis, unless they are STDs. You would just have to take professional opinions as to what your problem is. It is difficult for us to explain all the differences as there are a number of conditions that can affect the penis.

Customer: replied 2 years ago.
What do you think caused this?
Also is there a need for a full std screening
Expert:  Dr. S. Attili replied 2 years ago.

I don't see any need for a STD screen given that you did not have any direct sexual exposure

I am not sure what caused this.However there are hundreds of skin diseases that come and go and we are not able to identify a cause, everytime.

Customer: replied 2 years ago.
Do hour long soaks in bathtub or pool help or is it better to keep dry.
Also does the overuse of steroids have a reverse effect. Did I prolong this by using too much? Any other hints too speed up healing? Should I wrap in gauze to cut down friction
Expert:  Dr. S. Attili replied 2 years ago.
It is better to just do as advised previously. Soaking can make it worse. If you use steroids as recommended from now on, there should be no reverse effect. You wouldn't have done much damage. Please just do as recommended. You do not need to do anything else
Customer: replied 2 years ago.

will anxiety cause this to get worse. I am getting about 4 -5 hours of sleep at night max. I am constantly tired and worried. my head hurts constantly. it makes me feel a little light headed. I have to take a deep breath every once in a while to feel right. I have a hard time concentrating on things other than this. I am constantly thirsty and dont feel like eating. I read anxiety can cause rashes, but the rash is causing anxiety. Do you have a recomendation of what to do and can anxiety cause a rash?

Expert:  Dr. S. Attili replied 2 years ago.
anxiety does not cause but can exacerbate even minor rashes. Given your anxiety, I strongly recommend you see a dermatologist in person for reassurance.
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