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BMJ. 2007 April 28; 334(7599): 908.
PMCID: PMC1857777

Minerva

Julia Scott, senior house officer, Madanagopalan Ethundandan, specialist registrar, and Tim Flood, consultant

A 38 year old man recently presented with a two month history of oral ulceration. On examination we saw many aphthous ulcers in addition to a 25×15 mm erosive, erythematous, superficial ulcer, with irregular membranous tracts. Biopsy identified non-specific inflammation. Serological tests, including a Venereal Disease Research Laboratory test, a Treponema pallidum haemagglutination assay, and tests for IgG and IgM antibodies, were positive.

Oral ulceration caused by syphilis is rarely considered in the initial differential diagnosis, but the incidence of syphilis is increasing in Europe. Its highly infectious nature demands that clinicians maintain a high degree of suspicion when patients present with atypical oral ulcers.ulcers.

figure min2804.f1

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