A man, aged 47, consulted one of us because of an ulcer, which had made its appearance on the roof of his mouth. His previous history was in all respects negative. One day he noticed a little soreness on the roof of his mouth, and a small white spot, to which he paid no particular attention, until within a few days an ulcer developed, gradually becoming larger and more painful. Despite his negative history, a syphilitic condition was suggested by several physicians.
Physical examination revealed slight anisocoria, rather marked oral sepsis and gingivitis, especially around the posterior molars, an unpleasant fetid odor to the breath, and a well defined punched-out ulcer, about the size of a dime, situated on the hard palate, covered with a thick, creamy, easily removed exudate, and surrounded by a deep red, somewhat indurated areola. The base of the ulcer bled easily. The clinical picture certainly
BARKER LF, MILLER SR. PERFORATING ULCER OF THE HARD PALATE RESEMBLING TERTIARY SYPHILISBUT DUE TO A FUSOSPIRILLARY INVASION (SO-CALLED VINCENT'S ANGINA). JAMA. 1918;71(10):793–797. doi:10.1001/jama.1918.02600360009003