PMC6484239_01
Circular tender and infiltrated whitish plaques on the tongue in the photography taken after the first medical examination.. Given the absence of any other symptom the hypothesis of an isolated oral secondary syphilis was first excluded.
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Her blood count and C-reactive protein (CRP) levels were normal, her past medical and dermatological history were unremarkable, and the oral examination revealed circular whitish and gray plaques, infiltrated and with tender consistency located on the tongue (Figure 1); physical examination did not show skin or genital lesions.
A typical presentation of oral thrush.. Given the similarity of our patient condition to this classic scenario a misdiagnosis can be easily done.
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Because the clinical presentation simulated an oral candidiasis (Figure 2), the patient received an antifungal treatment in the first instance, without any improvement.
After an accurate diagnosis and two doses of Penicillin G 1.2 million units, a complete resolution of the lesions can be observed.
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The lesions regressed completely 15 days after therapy (Figure 3).