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| Fig. 28.4 Extragenital chancre of syphilis on the thumb. (Courtesy of the teaching files of Fitzsimons Army Medical Center.) |
Extragenital chancres occur in 5% of all cases of primary syphilis, although the incidence may be as high as 10%. The most common extragenital sites are the lip, which is associated with oral sex, and anus, which is associated with anal intercourse. Anal intercourse may also produce rectal or colonic chancres as high as 20 cm into the bowel. Other reported sites include the tongue, tonsil, finger, thumb (Fig. 28-4), eyelid, chin, nipple, umbilicus, axilla, and even the lower limb. A high index of suspicion is required to diagnose extragenital chancres.
Scott CM, Flint SR: Oral syphilis—reemergence of an old disease with oral manifestations,
Int J Oral Maxillofac Surg 34:58–63, 2005.
