Palatal Lesion Leading to the Diagnosis of Syphilis

Abstract

A 30-year-old woman presented with a painful lesion in the hard and soft palates with 3 months of evolution. Extraoral examination revealed painless brownish nodules in the nose, legs, back, palms of hands, and soles of feet. Incisional biopsy was performed under local anesthesia on the hard palate, and serology for syphilis (Venereal Disease Research Laboratory and fluorescent treponemal antibody absorption) yielded positive results. The histopathologic report was descriptive, containing the following: pseudoepitheliomatous hyperplasia and underlying inflammatory infiltrate containing neutrophils, histiocytes, and plasma cells, demonstrating foci of granulomatous inflammation with well-circumscribed collections of histiocytes and multinucleated giant cells; the findings were considered compatible with the clinical hypothesis of syphilis. The patient was referred for medical treatment, and follow-up visit within a short period demonstrated complete regression of the lesion in the palate. The patient is still undergoing medical treatment and follow-up.