Q. What causes black tongue and a purple patch on the skin after oral sex?

Answered by
Dr. Kiran Anaparthi
and medically reviewed by Dr. Divya Banu M
This is a premium question & answer published on Sep 24, 2019 and last reviewed on: Sep 27, 2019

Hi doctor,

10 days ago I had oral sex with CSW while drunk. I visited the GP the next day who gave me PEP, now nine days. Yesterday, I saw a hairy black tongue and freaked out. Visited local clinic, was prescribed mouthwash and Miconazole cream and did HIV 1 and 2 antibodies, due, hep B and VDRL- all negative.Also saw a small purple patch on the right forearm. I am not sleeping, worried sick.

I want to know the risk of HIV and if confirmed very low, what is probably going on with black tongue and a purple patch on the skin. Intend to get the HIV PCR test done in RSA on day 13. Please advise.

Dr. Kiran Anaparthi

Family Physician HIV/AIDS Specialist


Welcome to icliniq.com.

First, as per the history of 10 days contact, you will not possibly have HIV related symptoms. Second, the rash appears to be localized and not related to HIV or contact, it indicates local allergic reaction (attachment removed to protect patient identity). It resolves automatically or uses tablet Cetirizine.

Third, black tongue, not sure by pictures, if any, can be due to Nevirapine, which can give that and please specify the drug in PEP. Finally, using PEP after exposure is very good and it nullifies any risk. There are no known cases of getting HIV, post PEP use. So, continue PEP as advised. You are negetive and have very low chances but they are nullified by using PEP. So, worry not regarding HIV.

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