以舌斑块裂纹和口腔黏膜糜烂为首发表现的梅毒1例  

Fissured Tongue and Oral Mucosal Lesions as the First Manifestation of Syphilis:A Case Report

作　　者：杨溪[1] Rowida A.Albarmaqi 王红梅[1] 曹应葵 李玉叶[1] YANG Xi;Rowida A.Albarmaqi;WANG Hongmei;CAO Yingkui;LI Yuye(Department of Dermatology and Venereology,the First Affiliated Hospital of Kunming Medical University,Kunming 650000,China)

机构地区：[1]昆明医科大学第一附属医院皮肤性病科,云南昆明650000

出　　处：《中国皮肤性病学杂志》2022年第10期1178-1180,共3页The Chinese Journal of Dermatovenereology

基　　金：云南省防治艾滋病局项目;云南省“万人计划”名医专项(YNWR-MY-2018-039);云南省卫生和计划生育委员会医学领军人才(L-201613);云南省皮肤免疫疾病临床医学研究中心(2019ZF012);云南省皮肤与免疫性疾病临床医学中心(ZX2019-03-02)

摘　　要：患者女,16岁,下唇、上颚糜烂,舌部皲裂2个月。皮疹表现为下唇黏膜多发糜烂、溃疡,表面覆有少量不易擦除的白膜,触之较软,无软骨样硬度;上腭椭圆形红色糜烂面;舌面多处斑块、裂隙,触之较硬,有少量不易擦除的白膜覆盖;皮损区域均无明显触痛;生殖器黏膜未见明显异常。行梅毒血清学检查示:TPPA(+),1∶1280;TRUST(+),1∶64。刮取上腭、下唇、舌部皮损组织液行梅毒暗视野检查,均查见梅毒螺旋体。HIV抗体检测(-)和HSV抗体检测(-)。真菌镜检(-),真菌培养(-)。诊断:二期梅毒。予以“苄星青霉素,240万U,双侧臀肌注射,1次/周,连续注射3周”驱梅治疗。3个月后复查口腔黏膜皮损已基本愈合。A 16-year-old female presented with erosion on the lower lip and upper jaw and fissured tongue for 2 months.The rash was characterized by multiple erosions and ulcers on the lower lip mucosa,without cartilage-like hardness and covered with albuginea,which was not easy to be removed.Moreover,we observed red erosion on the upper palate,multiple plaques and fissures on the tongue surface covered with some albuginea,which was not easy to be removed,and rash without apparent tenderness and no obvious abnormality in the genital mucosa.Syphilis serology test showed:TPPA(+),1∶1280;TRUST(+),1∶64.The tissue fluid of the skin lesions of the upper palate,lower lip and tongue was scraped for syphilis dark-field examination,and Treponema pallidum was found.HIV and HSV antibody tests(-),fungal microscopy(-),fungal culture(-).Diagnosis of secondary syphilis was made.The patient was treated with benzathine penicillin,2.4 million U,bilateral gluteal muscle injection,once a week for 3 weeks,and the lesions had all healed after 3 months.

关 键 词：梅毒 裂纹舌 口腔黏膜病变 误诊 

分 类 号：R759.1[医药卫生—皮肤病学与性病学]