Up Above

A 32 year old man presents with a painless oral ulcer for one week.

Further questioning reveals that he had unprotected orogenital sex with two separate partners during the preceding month.

He is otherwise well, with an unremarkable medical history.

Select Relevant Investigations
Dark field microscopy

Performed

You remember that dark field microscopy of oral lesions is not recommended.
Rapid Plasma Reagin

Performed

The Rapid Plasma Reagin test is strongly reactive.
TPPA

Performed

The Treponema pallidum Particle Agglutination assay is reactive.
Biopsy of ulcer

Performed

A biopsy will be arranged next week.

Select Relevant Management
Metronidazole
Penicillin
Acyclovir
Topical Corticosteroids