Secondary syphilis with oral manifestation.

A 35-year-old man presented with a 3-week history of asymptomatic ulcerated lesions in the tongue (Fig. 1). He developed erythematous papules in the trunk and legs at the same time. The patient had no other systemic symptoms and reported having had unprotected sexual intercourse. Testing for the human immunodeficiency virus was positive. VDRL testing was positive with a titer of at least 1:64. A tongue biopsy revealed an inflammatory infiltrate suggestive of secondary syphilis with positive immunohistochemistry for Treponema pallidum (Fig. 2). The patient was treated with intramuscular benzathine penicillin for two weeks. The lesions completely resolved during a 4-week period. Syphilis is well known for