Primary Syphilis Oral — MFDS Part 1 MCQ

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ModerateMicrobiologyPrimary Syphilis OralMFDS Part 1

A patient presents with a solitary, painless ulcer on the lateral border of the tongue following oral sexual exposure. Which oral lesion is most characteristic of primary syphilis?

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Correct answer: E — Chancre

The correct answer is E, a chancre. Primary syphilis typically causes a solitary, painless ulcer at the inoculation site; in oral infection, the tongue and lips are common sites. Such an ulcer may be indurated and can be associated with non-tender regional lymphadenopathy. Mucous patches are more characteristic of secondary syphilis and are often multiple superficial oral lesions. A gumma is a late, tertiary manifestation. Hutchinson incisors are a dental feature of congenital syphilis. Oral hairy leukoplakia is an Epstein–Barr virus-associated lesion seen particularly with immunosuppression and is unrelated to syphilis.

Reference: Zhou X, Wu M-Z, Jiang T-T, Chen X-S. Oral Manifestations of Early Syphilis in Adults: A Systematic Review of Case Reports and Series. Sexually Transmitted Diseases. 2021;48(12):e209-e214. https://pubmed.ncbi.nlm.nih.gov/34433795/