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A 32-year-old man presented with a 2-month history of oral lesions that had been treated with cryotherapy and did not disappear. Physical examination revealed two leukokeratotic plaques with a kissing distribution. No other lesions in the skin or mucosa could be seen. Sexual transmitted diseases serologies, including HIV, syphilis, B and C hepatitis, revealed 1/2 RPR titles with positive Treponema pallidum particle agglutination (TTPA). The diagnosis was confirmed with a swab of the lesion for Polymerase Chain Reaction testing for T. pallidum. Treatment with a single dose injection of 2.4 million units of benzathine pencillin G was administered and lesions disappeared within 6 weeks (Fig. 1).
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