Hello
Two somewhat symmetrical "somethings" have appeared on the corners of my mouth (see li
2014-12-10 04:04:56
Hello Thanks for posting your query. I can understand your concern for the single painless ulcer on the penis. You have not mentioned anything regarding your sexual history and the STD blood tests that you have got done but for such a painless ulcerative solitary lesion on the penis syphilis and lymphogranuloma venereum are two possibilities which should be ruled out if you are sexually active. People with primary syphilis will develop one or more sores. The sores resemble large round bug bites and are often hard and painless. Although single dose of penicillin is sufficient to treat the sore but some resistant cases may need repeated doses. You have mentioned that many blood tests for STD’s have been done but confirmation is required with a treponemal test such as treponemal pallidum particle agglutination (TPHA) or fluorescent treponemal antibody absorption test (FTA-Abs). If these have not been done then you should get them done. Lymphogranuloma venereum also presents as painless genital ulcer that occurs at the contact site. To confirm the diagnosis real time PCR can be done. Please check your lab investigations and if these tests have not been done before then you can discuss about these tests with your dermatologist and get them done. Other than that since there was no response to the antibiotic you should get the ulcer cultured for fungal infection and viral infection (due to herpes although less likely)also. It is less likely to be related to stress and it is important to rule out infection as the source of this ulcer. Hope that this information helps and hope that you get better soon. Wishing you good health. 喵小姐 16:05:35 Hello Thanks for posting your query. I can understand your concern for these symptoms. I have checked the photograph and from the symptoms and photo it looks like angular cheilitis. Since the lesions are present symmetrically on both sides and clear liquid discharging from the lesion it looks more like angular cheilitis. Your history of recent staph infections and not changing the teeth aligners for such a long time may be the contributory factors. Even allergic contact dermatitis to the marijuana water pipe or your girlfriend’s lipstick can be contributing factors for the same. In nutshell all of these can be the causes for the pathology- angular cheilitis but not the diagnosis. So one important possibility is angular cheilitis. Apart from that although it does not look like a cold sore especially if there is no history of any unprotected oral vaginal or oral intercourse but since kissing was involved so it is important to rule out this possibility also. The HPV1 virus spreads through direct contact — through skin contact or contact with oral or genital secretions. Transmission may also occur through skin-to-skin contact during periods of asymptomatic shedding. So even if there was no visible cold sore the virus may spread if your girlfriend is having the HPV 1 infection. So to confirm the diagnosis you need to get a culture sensitivity (bacterial/ fungal and viral) of the sores and the discharge from the sores done. Then depending on the diagnosis treatment is planned. It may be topical or oral antibiotics/ antifungals and antivirals depending on the causative infection. Till you get the investigations done dry out the lesions completely by patting and air drying after washing with a mild soap and use petroleum jelly to lock out moisture. It is vital that the affected areas be clean and completely dry before application of the jelly. Also take some Vitamin B 12 supplements for some days and eat foods rich in vitamin B 12 like meat and poultry products. Hope that this information helps and hope that you get better soon. Wishing you good health.
2014-12-10 04:09:41
Hello Thanks for posting your query. I can understand your concern for the single painless ulcer on the penis. You have not mentioned anything regarding your sexual history and the STD blood tests that you have got done but for such a painless ulcerative solitary lesion on the penis syphilis and lymphogranuloma venereum are two possibilities which should be ruled out if you are sexually active. People with primary syphilis will develop one or more sores. The sores resemble large round bug bites and are often hard and painless. Although single dose of penicillin is sufficient to treat the sore but some resistant cases may need repeated doses. You have mentioned that many blood tests for STD’s have been done but confirmation is required with a treponemal test such as treponemal pallidum particle agglutination (TPHA) or fluorescent treponemal antibody absorption test (FTA-Abs). If these have not been done then you should get them done. Lymphogranuloma venereum also presents as painless genital ulcer that occurs at the contact site. To confirm the diagnosis real time PCR can be done. Please check your lab investigations and if these tests have not been done before then you can discuss about these tests with your dermatologist and get them done. Other than that since there was no response to the antibiotic you should get the ulcer cultured for fungal infection and viral infection (due to herpes although less likely)also. It is less likely to be related to stress and it is important to rule out infection as the source of this ulcer. Hope that this information helps and hope that you get better soon. Wishing you good health. 喵小姐 16:05:35 Hello Thanks for posting your query. I can understand your concern for these symptoms. I have checked the photograph and from the symptoms and photo it looks like angular cheilitis. Since the lesions are present symmetrically on both sides and clear liquid discharging from the lesion it looks more like angular cheilitis. Your history of recent staph infections and not changing the teeth aligners for such a long time may be the contributory factors. Even allergic contact dermatitis to the marijuana water pipe or your girlfriend’s lipstick can be contributing factors for the same. In nutshell all of these can be the causes for the pathology- angular cheilitis but not the diagnosis. So one important possibility is angular cheilitis. Apart from that although it does not look like a cold sore especially if there is no history of any unprotected oral vaginal or oral intercourse but since kissing was involved so it is important to rule out this possibility also. The HPV1 virus spreads through direct contact — through skin contact or contact with oral or genital secretions. Transmission may also occur through skin-to-skin contact during periods of asymptomatic shedding. So even if there was no visible cold sore the virus may spread if your girlfriend is having the HPV 1 infection. So to confirm the diagnosis you need to get a culture sensitivity (bacterial/ fungal and viral) of the sores and the discharge from the sores done. Then depending on the diagnosis treatment is planned. It may be topical or oral antibiotics/ antifungals and antivirals depending on the causative infection. Till you get the investigations done dry out the lesions completely by patting and air drying after washing with a mild soap and use petroleum jelly to lock out moisture. It is vital that the affected areas be clean and completely dry before application of the jelly. Also take some Vitamin B 12 supplements for some days and eat foods rich in vitamin B 12 like meat and poultry products. Hope that this information helps and hope that you get better soon. Wishing you good health.
2014-12-10 04:10:05
