Syphilis on the face in primary care: a rare sign of an increasingly common problem.

INTRODUCTION Syphilis in the UK continues to rise, particularly among men who have sex with men. In 2014, there was a 46% increase in syphilis in this risk group.1 Syphilis is a major problem in some parts of the world including Eastern Europe and is also seen in heterosexual men and women. Syphilis has also been diagnosed in white British individuals with no obvious risk factors. Two rapidly emerging social phenomena are likely to be helping the transmission of sexually transmitted infections (STIs) including syphilis. First, dating apps such as Tinder and Grindr are facilitating meeting more sexual partners.2 Second, the use of recreational drugs for enhanced sexual pleasure, known as chemsex, is associated with increased risk-taking behaviour.3 This article describes an unusual case of primary syphilis presenting with tongue and facial sores, and encourages primary care practitioners to consider testing for STIs including syphilis in individuals with oropharyngeal lesions.