Leone Corolina, Sugaya Norberto, Migliari Dante
Department of Stomatology, Oral Medicine Clinic, School of Dentistry, University of São Paulo, São Paulo, Brazil.
Case Rep Dermatol. 2020 Nov 26;12(3):262-265. doi: 10.1159/000510776. eCollection 2020 Sep-Dec.
Oral mucosal lesions presenting as erythematous patches usually pose difficulties for a clinical diagnosis. They elicit an array of differential diagnosis that mainly includes oral candidosis, contact mucosal reaction, oral lichenoid lesion, oral psoriasiform, autoimmune disease, and, not to forget, secondary syphilis. In this present case, all those above-mentioned possibilities were ruled out, while secondary syphilis stood as the main diagnosis. As this was also later excluded by a negative serological treponemal test, the final diagnosis rested on an ectopic manifestation of benign migratory glossitis (BMG), whose diagnosis was based on the clinical aspects of the lesions, along with their spontaneous disappearance in a short period of time (a hallmark of this condition) and the presence of fissured tongue, a manifestation that occurs very often in concomitance with BMG.
表现为红斑状斑块的口腔黏膜病变通常给临床诊断带来困难。它们引发一系列鉴别诊断，主要包括口腔念珠菌病、接触性黏膜反应、口腔苔藓样病变、口腔银屑病样病变、自身免疫性疾病，还有，别忘了二期梅毒。在本病例中，上述所有可能性均被排除，而二期梅毒成为主要诊断。由于后来梅毒螺旋体血清学检测呈阴性也排除了二期梅毒，最终诊断为良性游走性舌炎（BMG）的异位表现，其诊断基于病变的临床特征、病变在短时间内自发消失（该病症的一个标志）以及出现沟纹舌，沟纹舌是一种常与BMG同时出现的表现。
