Syphilitic Chancre Found on Nipple in Case Report
A medical report documents a rare extragenital syphilis infection located on a patient's nipple.
Updated on Oct. 13, 2026 in Sexual Health
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The New England Journal of Medicine published a case report detailing a rare instance of a syphilitic chancre found on a nipple. Extragenital chancres represent only about 2% of all primary syphilis cases.
Why it matters
Understanding atypical presentations of syphilis is crucial for clinical diagnosis as most extragenital sores occur on the lips or mouth. Healthcare providers must remain vigilant for rare symptoms despite overall national trends in infection rates.
A literature search identified only nine English-language case reports of chancres on the nipple or areola. While 190,242 total syphilis cases were recorded in the United States in 2024, the exact incidence of nipple-specific cases remains unknown.
The players
New England Journal of Medicine
This is a peer-reviewed medical journal that publishes original research and case reports on clinical practices.
CDC
The Centers for Disease Control and Prevention is the national public health agency responsible for tracking disease trends in the United States.
The details
Syphilis typically spreads through direct contact with sores during sexual activity, with nipple cases often linked to oral contact or local trauma. While primary and secondary syphilis cases in the U.S. fell by 21.7% in 2024, clinicians continue to encounter unusual clinical presentations.
Timeline
2014: A case report described primary syphilis on nipples and areolas.
2018: A literature search identified nine nipple chancre case reports.
2020: A report described a patient with secondary syphilis on the nipple.
March 2026: The CDC urged prioritizing penicillin shots for pregnant patients.
October 8, 2026: The New England Journal of Medicine published the case report.
Health Landscape
This rare clinical observation serves as a reminder of the diagnostic challenges posed by atypical syphilis presentations. It contrasts with the broader 2024 U.S. syphilis case reports which showed a decline in primary and secondary infections.
Patients should be aware that syphilis can present through non-genital sores, requiring medical evaluation for any unexplained lesions in the breast area. Early diagnosis remains the most effective way to prevent complications, as standard treatment for early syphilis involves a single injection of benzathine penicillin G.
The takeaway
Clinicians and patients should remain aware that syphilis can manifest in rare locations beyond traditional sites of infection. Prompt medical testing is essential if any unexplained sores or lesions appear, regardless of their location on the body.
Further reading
For more information on infection trends and clinical guidelines, visit the Sexual Health section.
Source note: This article includes information reported by Medical Daily.
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