Primary Syphilis Presenting as an Atypical Facial Chancre: Diagnostic Value of Extraoral Examination in Dental Practice

Syphilis, a chronic sexually transmitted infection caused by Treponema pallidum, is reemerging globally with increasingly diverse clinical presentations. Extragenital lesions, particularly on the face, may be misdiagnosed or overlooked during routine medical or dental examinations. We report the incidental diagnosis of primary syphilis in a 43-year-old male patient who presented for a routine dental evaluation. During extraoral examination, an asymptomatic, indurated ulcer on the left frontal region was discovered. Serological testing confirmed the diagnosis with positive Venereal Disease Research Laboratory (VDRL; 1:2) and Treponema pallidum hemagglutination assay (TPHA; 217.9) results. This case illustrates the crucial role of dental practitioners in recognizing systemic diseases through comprehensive extraoral assessment. Although primarily focused on oral health, dentists are often the first point of contact for patients and thus uniquely positioned to detect early manifestations of infectious conditions such as syphilis. A systematic extraoral examination should be an integral part of every dental visit. Early identification of atypical lesions not only facilitates timely medical referral but also enhances the dentist’s contribution to global public health surveillance.