Syphilitic Chancre of the Lips Transmitted by Kissing

Abstract

Primary syphilic chancre most often involved genitalia, with 12% to 14% extragenital lesions. This article describes a rare case of a female patient with labial ulcer and diagnosed as oral syphilis (OS), an uncommon presentation of primary syphilis. OS is transmitted through orogenital contact.This study is case report and literature review.We report a 27-year-old woman with painless, ulcerative, and indurated lesion on her lower lip and a 7-day history of symmetrically distributed nonpruritic macules. OS was diagnosed based on clinical presentations and serologic test and patient's oral ulcer was cured with intramuscular penicillin G benzathine. However, both the patient and her husband denied any orogenital sexual history before. In addition, her husband was also diagnosed as syphilis later in our clinic. He reported having orogenital contact with other people.Therefore, this is a rare case of OS transmitted through kissing.

Sonographic appearance of syphilitic induration mimicking squamous cell carcinoma in the lower lip: a case report

“…The differential diagnosis for initial induration of the lip includes cancer, traumatic ulcer, aphthous stomatitis, chancroid, herpes simplex, tuberculous chancre, and deep mycoses (for example, actinomycosis, Wegener’s granuloma, and Behçet syndrome) [ 11 , 13 ]. As a painless tumor, differential diagnosis could possibly exclude traumatic ulcer, aphthous stomatitis, herpes simplex, deep mycoses, and Behçet syndrome.…”

Oral Transmission of Sexually Transmissable Infections: A Narrative Review

“…18 The majority of cases of syphilis now occur in young adults, specially men who have sex with men (MSM). 19 Primary syphilis is characterized by the appearance of a chancre, which originates at the site of penetration of the organisms into the mucosa. The chancre is usually a painless and indurated ulcer with raised borders, which lasts between 3 and 6 weeks and is highly contagious.…”

“…Chancres are more frequent in the anogenital area; however, extragenital locations have been reported in 12% to 14% of cases. 19 From these, an estimated 40% to 75% occur in the mouth (Fig. 4), 3 with the oral mucosa being the most frequent site for extragenital primary syphilis.…”

“…Oral lesions in this setting are highly infectious, with a reported transmission rate of 18% to 80% during sexual contact. 19 Besides mucosal lesions, these patients often present also with associated ipsilateral adenopathies. 18 Secondary syphilis can also give rise to oral and pharyngeal manifestations, estimated to occur in approximately 30% of patients at this stage.…”

How to address the resurgence of syphilis in Canada

“…For example, accessible education campaigns that provide information on the relative ease with which syphilis can be transmitted -especially through intimate contact without inter course, such as kissing -may help to alter sexual behaviours. 12 Access to timely syphilis testing in remote regions of Canada may be limited, with test results taking up to 2-3 weeks, thus impeding efforts to treat cases and partners in a timely fashion. Use of pointofcare tests could solve this problem; however, no pointofcare tests for the detection of syphilis have been approved for use by Health Canada.…”