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Plaques en prairie fauchée.

Eric Farfour1, David Zucman2

  • 1Service de biologie Clinique, Hôpital Foch, 40 rue Worth, 92150, Suresnes, France.

Idcases
|April 14, 2021
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Summary

A mowed meadow tongue pattern, or "Plaques en prairie fauchée," can indicate secondary syphilis in men who have sex with men. Prompt diagnosis and penicillin treatment led to complete resolution of these painful oral lesions.

Keywords:
AIDSHIVMowed meadowPlaque en prairie fauchéeRashSyphilis

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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.