Plaques en Prairie Fauchée Tongue Lesions in Secondary Syphilis

A 29-year-old man with well-controlled HIV infection presented with a painful, whitish discoloration on his tongue for one week. He also reported scrotal ulcers that had resolved over the previous four weeks. Initial empirical treatment for suspected oral candidiasis was ineffective, prompting further testing.

A rapid plasma reagin test showed a titer of 1:32, and Treponema pallidum particle agglutination assay was positive, confirming secondary syphilis. The patient exhibited "plaques en prairie fauchée" tongue lesions, characterized by depapillated mucosal patches within a white coating on the posterior tongue.

Oral syphilitic lesions are highly variable and can mimic other conditions, complicating diagnosis. Penicillin G benzathine was administered, leading to complete resolution of lesions within seven days.

A 29-year-old man with well-controlled HIV infection presented with a painful, whitish discoloration on his tongue for one week. He also reported scrotal ulcers that had resolved over the previous four weeks. Initial empirical treatment for suspected oral candidiasis was ineffective, prompting further testing.

A rapid plasma reagin test showed a titer of 1:32, and Treponema pallidum particle agglutination assay was positive, confirming secondary syphilis. The patient exhibited "plaques en prairie fauchée" tongue lesions, characterized by depapillated mucosal patches within a white coating on the posterior tongue.

Oral syphilitic lesions are highly variable and can mimic other conditions, complicating diagnosis. Penicillin G benzathine was administered, leading to complete resolution of lesions within seven days.