A case of primary syphilis on both oral angles

Primary syphilis affects the genital and, less frequently, the extragenital regions. Approximately two-thirds of extragenital chancres occur above the neck, and about one-half of these are seen on the lips, the perioral region, or in the oral cavity. We present a case of a 32-year-old woman with a 2-month history of discharging ulcers on both oral angles. She had a history of orogenital sexual contact. Serologic tests for syphilis was positive, particularly the VDRL (1?128), confirmed by TPHA. The biopsy specimen showed a predominant infiltration of plasma cells in the dermis. The skin lesions improved after 4 weeks treatment with doxycycline.