Large stomatitis in a young woman

Excerpt

A 29-year-old Japanese woman with no known past medical history came to our clinic with the main complaint of a circular stomatitis and cervical lymphadenopathy since 4 weeks. On examination, the patient had a painless, sharply demarcated, sublingual, and ulcerated lesion (Fig. 1). She was in the 22nd week of pregnancy and sexually active with multiple male partners. Laboratory data revealed elevated titer of RPR (28.2 R.U.) and TPLA (28930.3 T.U.). Serological tests for HIV and HSV were negative. We clinically diagnosed primary syphilis in pregnancy. The diagnosis was later confirmed by histopathological findings on Warthin–Starry staining (Fig. 1) and the detection of T. pallidum DNA in tissue by PCR.

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