Reemerging syphilis
diagnosis from oral lesions
DOI:
https://doi.org/10.5935/2525-5711.20170007Palabras clave:
Syphilis, Treponema pallidum, Diagnosis, Oral, Sexually Transmitted DiseasesResumen
Background: Syphilis cases have increasing worldwide recently, indicating a resurgence of the disease. Its clinical features vary widely and often challenge the establishment of the diagnosis. Case report: A 23-year-old woman presented with multiple erosive and patchy oral lesions, dysphagia, and pain with onset of two months. Her medical history revealed that she also presented skin macules which were misdiagnosed as pityriasis by a dermatologist. Nontreponemic test was reagent. An incisional biopsy of an oral lesion was performed and the histopathological aspects were suggestive of syphilis. Treponemic test was positive, confirming secondary syphilis. The treatment consisted of penicillin for 3 weeks. After the 6-months follow-up, clinical and serological exams did not show any sign of the disease. Conclusions: Diagnosing syphilis by oral lesions can be difficult once it can mimic other affections. Additionally, the reemergence of this sexually transmitted disease in the last years demands its inclusion in the differential diagnosis of either erosive or ulcerate lesions.
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Singh PV, Patil R. Atypical oral manifestations in secondary syphilis. Indian J Dent Res. 2013;24:142-4.
Strieder LR, León JE, Carvalho YR, Kaminagakura E. Oral syphilis: report of three cases and characterization of the inflammatory cells. Ann Diagn Pathol. 2015;19:76-80.
Minicucci EM, Vieira RA, Oliveira DT, Marques SA. Oral manifestations of secondary syphilis in the elderly - a timely reminder for dentists. Aust Dent J. 2013;58:368-70.
Siqueira CS, Saturno JL, de Sousa SC, da Silveira FR. Diagnostic approaches in unsuspected oral lesions of syphilis. Int J Oral Maxillofac Surg. 2014;43:1436-40.
Ficarra G, Carlos R. Syphilis: the renaissance of an old disease with oral implications. Head Neck Pathol. 2009;3:195-206.
Kelner N, Rabelo GD, da Cruz Perez DE, Assunçao JN Jr, Witzel AL, Migliari DA, et al. Analysis of nonspecific oral mucosal and dermal lesions suggestive of syphilis: a report of 6 cases. Oral Surg Oral Med Oral Pathol Oral Radiol. 2014;117:1-7.
Kollipara R, Guidry JA, Tyring SK. Erythematous Papules and Vesicles on the Palms, Soles, and Oropharynx. JAMA Dermatol. 2015;151(7):783-4.
Compilato D, Amato S, Campisi G. Resurgence of syphilis: a diagnosis based on unusual oral mucosa lesions. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2009;108(3):e45-9.
Araujo JP, Jaguar GC, Alves FA. Syphilis related to atypical oral lesions affecting an elderly man. a case report. Gerodontology. 2015;32:73-5.
Brazil. Ministry of Health. Secretaria de Vigilância em Saúde. Boletim Epidemiológico. 2016;47(35):28 p. [cited 2017 Nov 7]. Available from: http://www.aids.gov.br/sites/default/files/anexos/publicacao/2016/59209/dst_aids_boletim_de_sifil_1_pdf_32008.pdf
Hertel M, Matter D, Schmidt-Westhausen AM, Bornstein MM. Oral syphilis: a series of 5 cases. J Oral Maxillofac Surg. 2014;72:338-45.
Leao JC, Gueiros LA, Porter SR. Oral manifestations of syphilis. Clinics (Sao Paulo). 2006;61:161-6.
de Paulo LF, Servato JP, Oliveira MT, Durighetto AF Jr, Zanetta-Barbosa D. Oral Manifestations of Secondary Syphilis. Int J Infect Dis. 2015;35:40-2.
Pires FR, da Silva PJ, Natal RF, Alves FA, Pinto CA, Rumayor A, et al. Clinicopathologic features, microvessel density, and immunohistochemical expression of ICAM-1 and VEGF in 15 cases of secondary syphilis with oral manifestations. Oral Surg Oral Med Oral Pathol Oral Radiol. 2015;121:274-81.
Cohen SE, Klausner JD, Engelman J, Philip S. Syphilis in the modern era: an update for physicians. Infect Dis Clin North Am 2013;27:705-22.
Lautenschlager S. Diagnosis of syphilis: clinical and laboratory problems. J Dtsch Dermatol Ges. 2006;4:1058-75.
Carbone PN, Capra GG, Nelson BL. Oral Secondary Syphilis. Head Neck Pathol. 2016;10:206-8.
Seibt CE, Munerato MC. Secondary syphilis in the oral cavity and the role of the dental surgeon in STD prevention, diagnosis and treatment: a case series study. Braz J Infect Dis. 2016;20:393-8.
