A solitary erosive patch on the left nipple

Abstract

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Primary Syphilis Presenting as Bilateral Nipple-areola Eczematoid Lesions

“…Among the 6 patients described with solitary syphilitic chancre on the nipple, bites and nibbles on the nipple during sexual intercourse were documented in 2 patients (3, 5) and 3 patients (2, 4), respectively, and in the remaining case, oral contact on the nipple without sexual intercourse was documented prior to the onset of nipple syphilitic chancre (6). Syphilis is generally transmitted through contact with the infectious patients and facilitated by minor trauma of the skin or mucous membrane.…”

An erythematous nodule on the nipple: An unusual presentation of primary syphilis

“…The first cases were reported in 2006 by Lee et al , who described two patients with nipple lesions manifest as solitary unilateral nodules . Since then, only five additional cases have been reported in the English language literature …”

“…In recent years, a few reports describing cases of primary syphilis involving the nipple have been published (Table ). All of them occurred in males, and in many of them the lesions appeared shortly after the nipple was bitten during sexual intercourse with a prostitute or oral contact with an infected person . Lesions were described as unilateral nodules, ulcers, erosive and erythematous plaques or crusted patches .…”

“…All of them occurred in males, and in many of them the lesions appeared shortly after the nipple was bitten during sexual intercourse with a prostitute or oral contact with an infected person . Lesions were described as unilateral nodules, ulcers, erosive and erythematous plaques or crusted patches . One patient presented with bilateral involvement of the nipples with eczematoid‐like lesions, while another had an overlap between primary and secondary syphilis at the same time …”

“…If the sexual partner has a chancre in the oral mucosa or tongue, it is possible that T. pallidum can be inoculated into a nibbling site of the nipple. Second, if a sexual partner has active or latent secondary syphilis, it is possible that minor trauma may have occurred in his/her oral mucous membrane, such that T. pallidum was released with blood and was inoculated onto the nipple mixed with saliva . According to Centers for Disease Control and Prevention (CDC) guidelines, benzathine penicillin G 2.4 million units IM in a single dose is the preferred regimen of treatment for primary syphilis…”