A Case of Secondary Syphilis with Mucous Patches on the Hard Palate

Abstract

A rare case of secondary syphilis showing mucous patches on the hard palate is reported. A 31-year-old male had two erosive patches which were slightly raised on his hard palate. A linear lesion was also present on the inside of his right alveolar process. Many red-brown macules on his abdomen and bilateral inguinal lymphadenopathy accompanied these symptoms. The serological tests for syphilis were positive: VDRL test 1:512, TPHA test 1:20,480, and IgM-FTA-ABS test 1:40. Immunohistochemical staining with rabbit monoclonal antibody to Treponema pallidum by the biotin-streptoavidin system detected treponemal organisms in the paraffin-embedded specimen from his mucous patch. A diagnosis of secondary syphilis was made, and he was given amoxicillin (AMPC) at 750 mg per day for 4 weeks. His eruptions, including the mucous patch, healed in a week.

Oral Syphilis: a retrospective analysis of 12 cases and a review of the literature

“…In 5 (26%) cases, the oral lesions were multiples (Compilato et al , ; Lu and Eng, ; Junkins‐Hopkins, ; Mani, ), while in the other 14 (74%) cases, the most frequent site of onset of the disease was the tongue (five cases, 37%) (Ikenberg et al , ; Bruce et al , ; Aquilina et al , ; Oztürk et al , ), followed by the labial (three cases, 21%) (Rajlawat et al , ; Lu and Eng, ; Mani, ), the buccal mucosa (two cases, 14%) (Ibrahim and Malu, ; Lu and Eng, ), the palate (three cases, 21%) (Murrell, ; Lu and Eng, ; Ban et al , ), and the gingiva (1 case, 7%) (Ficarra et al ,).…”

“…The secondary lesions displayed a heterogeneous pattern: mucosal patches in 8 (42%) patients (Lu and Eng, 2002;Ozt€ urk et al, 1998;Ban et al, 1995;Mani, 1984), solitary or multiple ulcerations in 7 (37%) patients (Rajlawat et al, 2011;Ikenberg et al, 2010;Murrell, 2009;Bruce et al, 2009;Lu and Eng, 2002;Ficarra et al, 1993), a leukoplakia-like plaque in 2 (11%) cases (Compilato et al, 2009;Aquilina et al, 2003), aphthous lesions in 1 (5%) case (Ibrahim and Malu, 2009), and pseudomembranous lesions in 1 (5%) case (Junkins-Hopkins, 1996).…”

Secondary Syphilis Presenting as Glossodynia, Plaques en Prairie Fauchée, and a Split Papule at the Oral Commissure: Case Report and Review

“…They may be accompanied by a concomitant cutaneous eruption [4] and cervical lymphadenopathy [9, 19, 29], which can occasionally dominate the clinical picture [30, 31]. Published case reports and case series testify the outstanding variability of clinical presentation.…”

“…Mucous patches may also present as whitish plaques that may coalesce and form serpiginous lesions, referred to as snail-track ulcers [36]. They present most often on the soft palate, pillars, tongue, and vestibular mucosa [4, 13, 18, 23, 35]. When the dorsal aspect of the tongue is affected, they will efface lingual papillae [11, 21].…”

“…Despite its clinical heterogeneity, oral manifestations can usually be correctly attributed to secondary syphilis when a concomitant skin eruption is present [3, 4]. However, a patient with undiagnosed syphilis may occasionally have only oral lesions [5–14].…”