Secondary syphilis may involve the oral mucosa and can be severe.

Barriers to diagnosis:

(1) no history of sexually transmitted disease (HIV, other)

(2) no or limited extra-oral lesions (isolated oral lesions)

(3) painless lesions

(4) another diagnosis suspected (initial misdiagnosis)


Manifestations may include:

(1) false cheilitis (fausse cheilitis): split papules at the labial commissure, typically unilateral

(2) fissures

(3) intraoral papules or nodules

(4) depapillation or mucous patches on the tongue

(5) red or white plaques

(6) submandibular lymphadenopathy

(7) erosive or ulcerative lesions

(8) leukokeratotic lesions


The lesions often will resolve within 2 weeks of starting appropriate therapy.

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