Primary syphilis presenting as bilateral nipple-areola eczematoid lesions.

Primary syphilis caused by Treponema pallidum usually develops in the genital region after sexual contact as syphilitic chancres. However, syphilitic chancres can also occur in extragenital regions, including sites of lips, tongue, palate, conjunctiva, neck, breasts, abdomen, intrascapular region, arms, palms, fingers, and thighs with an estimate of incidence ranging from 2% to 31% (1). Solitary syphilitic chancre occurring on the nipple region has been described scarcely in the literature (2–6). Herein, we describe a case of primary syphilis occurring on both nipple-areolas as eczematoid lesions in a male patient, which may be underreported.