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The gingiva and the palate are the most affected sites.28 Syphilis Likewise in the skin, syphilis in the oral mucosa also shows a huge variety of presentations at different stages of the disease, making it a diagnostic challenge in clinical practice.7 Primary syphilis manifests its chancre as a single, deep ulcer with an erythematous, purplish or brownish base and irregular, raised borders, usually accompanying cervical lymphadenopathy (Fig