Case 29

This 34 year-old white female presents with a discrete, white, necrotic lesion of the maxillary lip of 2 weeks duration.  The filmy, white patch is nontender but does not appear to be healing.  The patient has a history of sexually transmitted diseases.

            a.        Provide 3 reasonable differential diagnoses.

            b.        What stage of syphilis is this lesion most consistent with?

            c.         What laboratory test would you order for this patient to confirm your suspicion?

Final Diagnosis

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