“…Examples include venereal and nonvenereal transmission to traumatized skin (eg, human bites, scratches, unprotected hands of health care providers, shared syringes). [14][15][16][17] This mechanism also explains the high incidence of oral chancres and anal chancres, specifically in patients who engage in anal sex. 5 Additionally, the high rate of coinfection of syphilis and HIV can be attributed, at least in part, to the mucosal barrier disruption associated with chancre formation in addition to immunologic and behavioral factors.…”