Plaques en prairie fauchée

Highlights • Mowed meadow pattern of the tongue also called “Plaques en prairie fauchée” is a manifestation of secondary syphilis. • It results from the hematogenous dissemination of Treponema pallidum from syphilitic chancres. • Suspected case is confirmed by serology or nucleic acid amplification on a tongue swab.
We report a clinical picture of a mowed meadow pattern of the tongue in a 29-year-old sexually active man who has sex with men. The painful lesions also called "Plaques en prairie fauchée", occur in the context of the discovery of a postive HIV serology. The diagnosis of secondary syphilis was confirmed by a positive syphilis serology (nontreponemal RPR test title of 64) and a positive Treponema pallidum PCR, amplifying the tpp47 gene, on a tongue swab. The lesions completely resolve with a penicillin treatment.