Lesion on perineum

[forrest1921]

Hello, I recently found a small lesion on the left edge of my girlfriend's perineum.  It is very shallow and perhaps 1/8" wide and 1/4" long.  I believe it was smaller two weeks ago.  She says it doesn't itch and it is painful when she wipes the area, which is how she discovered it.  She traveled to Asia in January.  I'm positive she has had no other partners but me, but last October, I had condom protected intercourse with an Asian female massage worker as well as a caucasian CSW I found on backpage (my girlfriend is unaware of this).  Subsequent to those encounters I did three separate sti screens for chlamydia, gonorrhea, syphilis, hiv, hep, and hsv1/2, at 2 weeks, 6 weeks and 10 weeks and they all came back negative, except for hsv1, which I already knew I had.  I have been regularly checking myself since the encounters and have never found any lesions - even to the point of seeing an STD nurse and a Urologist to verify that things I saw were not lesions.  My wife and I are of european descent.

I have urged her to see a doctor, and she plans to do so but hasn't yet.  Her delay is driving me crazy since I don't believe that I could have given her this, but don't know how else she would have gotten it.  

So - the question is, is there any possibility that I may have picked something up, not had symptoms, but passed it on to her?

Thank you for your help and for the forum.

[Edward W Hook, MD]

"just to be clear - assuming it is not a genital wart, for example, it is highly unlikely that I could have passed something on to her without symptoms myself? " --Correct  EWH

[forrest1921]

Sorry about the multiple replies - by lesion, I mean shallow ulcer.

[forrest1921]

Thank you for your quick reply.  So - just to be clear - assuming it is not a genital wart, for example, it is highly unlikely that I could have passed something on to her without symptoms myself?

[Edward W Hook, MD]

Welcome to our Forum.  I'll try to help but without knowing what the lesion you have discovered is, it is not possible to determine if this lesion might reflect an STI or not.  The only STI which the lesion you describe might be is a genital wart and this is a possibility however the linear description you provide is not typical and most typically genital warts are acquired due to contact with other warts.  Further, the fact that, even with professional evaluation, you have not seen warts on yourself makes this unlikely.  It is also quite possible that this lesion represents some other benign dermatological process.  The only way to know is with examination by a knowledgeable clinician (a word of caution is appropriate here- all too many clinicians assume that most such lesions are in fact warts and thus if you really wish to know what this is, dermatological examination and perhaps even a biopsy will be needed).  

If the lesion you describe were a wart, there are no major health consequences for your wife. Such lesions typically resolve on their own with the passage of time (18 months- 2 years).

I hope these comments are helpful. EWH