Plaques en prairie fauchée

Area of Science:

• Infectious Diseases
• Oral Medicine
• Dermatology

Background:

• The "mowed meadow" or "Plaques en prairie fauchée" pattern of the tongue is an uncommon clinical manifestation.
• This specific oral lesion presentation has been rarely associated with underlying systemic infections.

Purpose of the Study:

• To describe the clinical presentation of a "mowed meadow" tongue pattern in a patient with secondary syphilis.
• To highlight the importance of considering syphilis in the differential diagnosis of unusual oral lesions, especially in at-risk populations.

Main Methods:

• Clinical case report of a 29-year-old sexually active man who has sex with men.
• Diagnostic confirmation included rapid plasma reagin (RPR) testing and Treponema pallidum polymerase chain reaction (PCR) on a tongue swab.
• Treatment and follow-up of the patient's oral lesions.

Main Results:

• The patient presented with painful "mowed meadow" tongue lesions coinciding with a positive HIV serology.
• Syphilis serology was positive (RPR 64), and Treponema pallidum PCR of a tongue swab confirmed the diagnosis.
• Complete resolution of the oral lesions was achieved following penicillin treatment.

Conclusions:

• The "mowed meadow" tongue pattern can be a sign of secondary syphilis.
• Early diagnosis and appropriate treatment, such as penicillin, are effective in resolving these syphilitic oral manifestations.
• This case underscores the need for thorough diagnostic workups for oral lesions in patients with risk factors for sexually transmitted infections.