Dr. Basti Bharatesh Devendra
Dermatology
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hello doctor,
I had sex with a sex worker. But I cleaned myself up after that. Is there any chance of herpes transmission? A few days back, I had a small pimple kind of thing on my hand, and the doctor said it was a wart. It was surgically removed after a while. I got terrified and asked him whether it was an HPV wart, but he categorically refused it. I am sending you reports of that, could you please tell me what you think? I asked a few doctors and researched on the internet, and everything tells me that I have nothing to worry about. They say there is relatively no chance of any STD transmission. Is it true? I am worried. I have a two-year-old daughter who my wife breastfeeds, and I am scared she might also get infected. Is there any chance of HIV transmission or any other STD? Is there even a slight chance of any transmission? Could you please tell me if there is any risk of getting any STD? Please help.
Hi,
Welcome to icliniq.com.
I understand your concern. The chances of transmission of the human immunodeficiency virus (HIV) by the given description is nil. Sexually transmitted diseases (STDs) like herpes simplex virus (HPV) can be transmitted by skin-to-skin contact, kissing, or penetration. There are possibilities of higher transmission if there are active lesions on the sex worker at the time of contact. The lesion in the reports (attachments removed to protect the patient's identity) does not appear to be due to an HPV wart. Hope this helps.
Patient's Query
Thank you for your response.
Yes, there was no skin-to-skin contact or kissing. So are you sure I have not contracted an STD? I do not remember whether I cleaned my hand with disinfectant after touching her private parts. Does that increase my chance of being infected? Please help.
Hello,
Welcome back to icliniq.com.
I understand your concern. If there is no intercourse or kissing then the chances of sexually transmitted diseases (STD) and human immunodeficiency virus (HIV) are nil. STD transmission is unlikely for the activities you have described earlier. I hope this helps.
Patient's Query
Thank you for your response.
Do I need any testing? Also, will I contract an STD if I get a scratch on my body from the nail of the sex worker? I am sending you my reports where this small pimple comes and goes. Hair follicles come out, and then it subsides. Is it folliculitis or molluscum contagiosum ? Can you suggest any medicine? Is it dangerous or contagious? I am also sending reports of my daughter's leg having small dry skin rashes, which she keeps on scratching. Is it a problematic skin issue? Would you please give me your opinion on this?
Hello,
Welcome back to icliniq.com.
I understand your concern. If there is no intercourse or kissing then the chances of sexually transmitted diseases (STDs) and human immunodeficiency virus (HIV) are nil. Please attach the reports once again.
Patient's Query
Thank you for your response.
I will send them again.
Hello,
Welcome back to icliniq.com.
I understand your concern. In my opinion, the lesions on your thigh appear to be due to folliculitis. I suggest you to start with topical antibiotic cream like Fucidin (Fusidic acid). Your daughter's leg lesions may be due to eczema. You can consult your dermatologist for further diagnosis and management. I suggest you to try steroid cream like Eumosone (Clobetasone (0.05% w/w)) cream. Hope this helps.
Patient's Query
Thank you doctor.
I still have a doubt. It is exactly four weeks since the incident happened. If I take a test today of HIV antigen, VDRL, HSV 1, and HSV 2, will it give me correct results? Are there any chances of false-negative, or can I trust the result and move on? Would you please give me your opinion on this?
Hello,
Welcome back to icliniq.com.
I understand your concern. You can go for all these tests after three months of exposure. In my opinion, right now, they will not be considered conclusive. They will be inconclusive. Hope this helps.
Patient's Query
Hello doctor,
Thank you for your response. Does my exposure which I explained earlier, require testing? Can I get an STD if the sex worker scratched me with her nail? Would you mind giving me your opinion on this?
Hello,
Welcome back to icliniq.com.
I understand your concern. I do not see the need for sexually transmitted diseases (STD) tests based on the information you have provided. You can go for STDs tests after three months to relieve anxiety. And to answer your question, no, scratching with nails does not transmit STDs.
Patient's Query
Thank you doctor for your response.
What kind of STDs can be transmitted with a nail scratch? Is it really possible? Is there any chance of HIV transmission? Please let me know what you think about this.
Hello,
Welcome back to icliniq.com.
I understand your concern. I suggest you not to overthink about this. In my opinion, STDs are not transmitted by nails or by scratching with nails. Only if they have a bad intention or purposefully want to infect you, they do so by any means. It is uncertain in your scenario. Hope this helps.
Patient's Query
Thank you doctor.
Yesterday, I took all the tests. All of them were negative. I am attaching the results for your reference. Now, are there any chances that it could be false-negative? If I had no other exposures. The last exposure, which I explained to you earlier, was four weeks before. Can I be 100 % sure and forget this?
Hello,
Welcome back to icliniq.com.
I understand your concern. Based on the results it is good that they are all negative (attachments removed to protect the patient's identity). The chances of these tests coming positive later are almost nil. It is considered conclusive after three months of exposure. So go for the tests after three months of exposure to completely relieve anxiety and for conclusive results.
Patient's Query
Thank you doctor,
Doctor, since I did not have a calm mind, I did another HIV antigen & antibody test after 46 days. It came negative. I researched a lot on the internet & everywhere, it says that six weeks antigen test is 100% conclusive. Is it true, doctor? Can I be at peace? Had no other exposure other than what I explained before. Attaching both the previous and present test reports. The point is 0.07 earlier and 0.09 after 46 days. Hope there is no difference. Please help.
Hi,
Welcome back to icliniq.com.
I understand your concern. It is good that the HIV combination test is negative after 46 days. With the given risk exposure and the HIV test results, it can be considered conclusive. Do not worry about the title values. If you are too anxious, you can go for an HIV antibodies test after three months of exposure to be relieved of anxiety. Hope this helps.
Patient's Query
Thank you doctor,
Cannot wait for one and a half months. I need to remove it from my head because it affects my family state. I have been maintaining a distance from my wife and daughter. There can be no chance, right doctor? Secondly, the VDRL and herpes test, which I took after four weeks, is conclusive. No need to retest for that also, right?
Hi,
Welcome back to icliniq.com.
I understand your concern. For conclusive test results, if exposed, we usually suggest after three months exposure. As your exposure risk is almost nil, there will be no need for these tests. If you are still anxious or doubtful of the exposure, go for post three months of exposure tests. Hope this helps.
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Dermatology
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