“… 2 Skin biopsy is characterized by spongiotic dermatitis with lymphocytic infiltration in the superficial dermis. 9 Primary syphilis is a main cause of genital ulcer disease caused by treponema pallidum, which can penetrate epidermis or mucosal epithelium through tiny wounds after sexual exposure. 2 , 9 Primary syphilis may present in extragenital regions including the lips, oral mucosa, tongue, conjunctiva, 10 chin, neck, anus, arms, abdomen, and nipple–areola.…”