A man in his 60s with no significant medical history presented to the dermatology clinic for evaluation of a gray-white plaque on his soft palate. These findings developed over the prior week and did not improve after treatment with 3 days of oral cefuroxime. The patient reported no sore throat, dysphagia, hoarse voice, cough, dyspnea, nausea, vomiting, headache, fever, night sweats, weight loss, rash, or genital, rectal, or oral ulcers over the past 6 months. He was taking no regular daily medications, did not smoke cigarettes, and had no history of oral trauma. Over the prior 6 months, he reported sexual contact with 1 male partner. Physical examination revealed irregular gray-white ulcers with a surrounding erythema on the soft palate, uvula, and tonsils (Figure 1) and nontender bilateral submandibular lymphadenopathy. His tongue was of normal appearance, and he had no skin lesions or mucosal erosions in the anal or genital areas.