Syphilitic Leukoplakia
Article Information
MJ Vivancos-Gallego1*, Mónica Garcia-Cosio2, Inmaculada Espinosa-Monroy1
1Department of Infectious Diseases. University Hospital Ramón y Cajal and IRYCIS, Universidad de Alcalá, Madrid, Spain; CIBERINFEC, Madrid, Spain
2Pathology, Hospital Universitario Ramón y Cajal, IRYCIS, Madrid, Spain; Universidad de Alcalá de Henares, Madrid, Spain; CIBERONC, Madrid, Spain
*Corresponding Author: M.J. Vivancos-Gallego, Department of Infectious Diseases. University Hospital Ramón y Cajal and IRYCIS, Universidad de Alcalá, Madrid, Spain; CIBERINFEC, Madrid, Spain.
Received: 20 October 2022; Accepted: 03 November 2022; Published: 31 January 2023
Citation: MJ Vivancos-Gallego, Mónica Garcia- Cosio, Inmaculada Espinosa-Monroy. Syphilitic Leukoplakia. Archives of Clinical and Medical Case Reports 7 (2023): 42-43.
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Leukoplakia; Oral; Syphilis; Ulcer
Article Details
1. Case Report
A 28-year-old male was referred by his primary care physician for work-up of possible oral candidiasis. He had been diagnosed with asymptomatic HIV-infection 18 months earlier and had undetectable viral load under antiretroviral treatment. The patient reported a history of multiple unprotected sexual encounters over the preceding 3 months. Physical examination showed painless and confluent whitish mucous patches (about 2 cm long) with erythematous border on the left soft palate which did not scrape off with a tongue depressor (Panel A). A biopsy specimen from the damaged mucosa was obtained and revealed hyperplasia of the epithelium and a dense inflammatory infiltrate in the corion, composed mainly by plasma cells (Panel B and C). Immunohistochemistry highlights numerous treponemal spirochetes, brown chromogen (Panel D and E). Treponemal tests (EIA and TPPA) were reactive and Rapid Plasma Reagin test (RPR) was positive (titer, 1:32). A diagnosis of syphilis was made. The patient was initially treated with intramuscular penicillin G benzathine. At 3-month follow-up he had complete resolution of palate lesion.
Competing Interest
M.J.V.G reports grants and personal fees from Gilead and ViiV outside the submitted work. All other authors report no potential conflicts of interest.
Acknowledgments
M.J. V-G. is supported by a grant from the Instituto de Salud Carlos III (Contratos Juan Rodés, JR19/00031).