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Case Reports in Medicine
Volume 2017, Article ID 1980798, 5 pages
https://doi.org/10.1155/2017/1980798
Case Report

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

1Hospital Universitário Gaffrée e Guinle, Centro de Ciências Biológicas e da Saúde, Universidade Federal do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
2Programa Municipal de HIV/AIDS de Miracema, Posto de Saúde Dr. Irineu Sodré, Av. Nilo Peçanha 59, 28460-000 Miracema, RJ, Brazil

Correspondence should be addressed to Walter de Araujo Eyer-Silva; rb.moc.gi@reye.retlaw

Received 9 March 2017; Accepted 31 May 2017; Published 12 July 2017

Academic Editor: Indraneel Bhattacharyya

Copyright © 2017 Walter de Araujo Eyer-Silva et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Syphilis has been coined “the great imitator” due to its extreme heterogeneity of presentation and mimicry of other conditions. Therefore, it is essential that physicians be familiar with the full spectrum of its manifestations. Syphilis may also lead to oral lesions that, occasionally, are unaccompanied by concomitant tegumentary findings. Such patients will pose unique diagnostic challenges. We report the case of a 45-year-old HIV-infected male patient in whom secondary syphilis presented with burning mouth and dysgeusia that progressed to glossodynia and odynophagia. Examination revealed painful, shallow erosions on the posterior aspect of the tongue, in a pattern of plaques en prairie fauchée. A painful split papule (fausse perlèche or false angular cheilitis) was also present in the left commissure. There were no cutaneous lesions. The oral lesions were considered highly suggestive of secondary syphilis. A novel VDRL assay (which was previously negative) yielded a titer of 1/128. Complete clinical remission was rapidly achieved after initiation of penicillin therapy. A comprehensive review of the literature on oral manifestations of syphilis is offered.