Syphilitic chancre in the mouth: an unusual location. Case report

Main Article Content

Grecia Figueroa-Ramos http://orcid.org/0000-0003-2068-6911
Georgina Rodríguez-Gutiérrez http://orcid.org/0000-0002-6193-0450
Judith Domínguez-Cherit http://orcid.org/0000-0003-3542-4615

Keywords

HIV Infections, Syphilis, Chancre

Abstract

Background: Syphilis is an infectious disease caused by the spirochete Treponema pallidum, transmitted mainly by direct contact with the lesion. Primary syphilis usually presents with a chancre at the site of infection, which is highly contagious and resolves without treatment. The aim of this article is to illustrate an unusual location of a syphilitic chancre, in order to consider this diagnosis within the approach to patients with oral ulcers.


Clinical case: a 30-year-old man who presented a dermatosis located in the left labial commissure, characterized by a painless ulcer of 1 cm in diameter of 20 days of evolution. The patient has a history of HIV/AIDS. A punch biopsy of the ulcer was performed with which the diagnosis of syphilitic chancre was made. The patient was treated with benzathine penicillin G, presenting resolution of the dermatosis.


Conclusions: Primary syphilis is characterized by the development of the syphilitic chancre, which is the first manifestation of syphilis in up to 60% of cases. Extragenital presentation is rare, with only 12-14% of all cases, and of these between 40-70% occur in the mouth, being the lips the most frequent location. Oral manifestations can represent a diagnostic challenge due to its wide spectrum of clinical presentations.

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