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

A crusted ulcer of the nipple

“…2 To the best of our knowledge, extragenital syphilitic chancres on nipple region have been described in 16 patients (3 females, 13 males) (Table 1). [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17] Bites, nibbles or trauma on the nipple during sexual intercourse were reported in ten patients, [3][4][5][6]9,[11][12][13]15 whilst one patient had had genital-nipple contact 8 and another both nipple bite and nipple-genital contact. 17 Lesions were variably described as erosions, ulcers, and crusted plaques.…”

Extragenital Chancre in Men Who Have Sex with Men: Six Cases from China

“…Nipples are often chapped or erosive due to being played with, stimulated, and bitten by sexual partners with clear boundaries. The chancre occurring in the nipple should be differentiated from Paget's disease of the breast, eczema of the nipple, herpes simplex virus infection, erosive adenomatosis of the nipple, basal cell carcinoma of the nipple, leishmaniasis, melanoma, and skin lymphocyte proliferation (Podlipnik et al, 2015;Sim et al, 2010;Yu et al, 2012).…”

A Case of Syphilitic Chancre of the Tongue

“…At least 5% of syphilitic chancres are extra genital and the oral mucosa is the most frequently exposed site, because of unprotected urogenital contact, wrongly considered as a safe sex practice [13]. Extra genital chancres are often misdiagnosed due to lack of consideration as STIs, since lesions do not involve genitalia [14]. We could speculate that the real incidence of extra genital syphilitic chancres is higher than the 5% reported in the literature and would like to point to the necessity for the clinicians to maintain a high index of suspicion.…”