Abstract
BACKGROUND Condyloma lata is a hallmark of secondary syphilis, presenting as moist, flat, or raised lesions typically located in the genital and perineal regions. However, oropharyngeal condyloma lata (OCL) is a rare and often underrecognized manifestation of secondary syphilis. Its atypical presentation can lead to diagnostic challenges, particularly in the absence of classic systemic features of syphilis. CASE REPORT We report the case of a 43-year-old man with HIV and chronic hepatitis C virus co-infection, diagnosed 2 years prior. The patient had been receiving antiretroviral therapy with tenofovir alafenamide, emtricitabine, and dolutegravir, achieving virologic suppression for 6 months. His CD4 T-cell count was 331 cells/μL. He presented with a sore throat and painful swallowing lasting 1 week. On examination, a single, non-tender, moist, broad-based whitish plaque with peripheral erythema was observed on the soft palate mucosa. There was no rash, lymphadenopathy, hepatosplenomegaly, or hair loss. Differential diagnoses included atypical oral candidiasis and viral warts. However, a positive rapid plasma reagin (RPR) test with a titer of 1: 128 and a reactive Treponema pallidum electrochemiluminescence immunoassay confirmed the diagnosis of OCL. The patient received a single dose of 2.4 million units of intramuscular benzathine penicillin G, leading to the complete resolution of symptoms within 7 days. CONCLUSIONS This case underscores the importance of considering OCL in the differential diagnosis of unexplained oropharyngeal lesions, particularly in patients with risk factors for syphilis. Early recognition, serological testing, and treatment with a prompt single dose of intramuscular benzathine penicillin G are crucial to prevent misdiagnosis, delayed care, and disease progression.