ORAL SECONDARY SYPHILIS IN A PATIENT WITH HUMAN-IMMUNODEFICIENCY-VIRUS INFECTION

This report describes a case of secondary syphilis in a patient with t he human immunodeficiency virus (HIV) in whom the main clinical presen tation of the disease was an extensive oral lesion. Few reports in the literature have focused on oral manifestations of syphilis in HIV-inf ected patients; most of these reports have dealt with a rare manifesta tion of secondary syphilis, the ulceronodular variety or lues maligna. However, in the case reported here the lesions were painless, smooth, white, oral plaques and papules on an erythematous base with a serpen tine and reddish outline corresponding to the description of mucous pa tches. The differential diagnosis of this lesion may include oral squa mous carcinoma, leukoplakia, erythroleukoplakia, candidosis, lichen pl anus, and granulomatous diseases. This case report emphasizes the impo rtance of considering secondary syphilis in the differential diagnosis of oral lesions in HIV-infected patients, reinforces the importance o f follow-up on the patient, and highlights the consideration for routi ne serologic testing for syphilis in all HIV-infected patients.