A superficial grayish area of mucosal necrosis is seen in secondary syphilis; this lesion is termed a “mucous patch.” Secondary syphilis usually develops within 6 weeks after the primary lesion and is characterized by diffuse maculopapular eruptions of the skin and mucous membranes.
On the skin, these lesions may present as macules or papules.In the oral cavity, the lesions are usually multiple painless grayishwhite plaques overlying an ulcerated necrotic surface. The lesions occur on the tongue, gingiva, palate, and buccal mucosa.Associated systemic signs and symptoms (including fever, sore throat, general malaise, and headache) may also be present. The mucous patches of the secondary stage of syphilis resolve within a few weeks but are highly infective because they contain large numbers of spirochetes.