Secondary syphilis in the oral cavity and the role of the dental surgeon in STD prevention, diagnosis and treatment: a case series study

Seibt, Creta Elisa; Munerato, Maria Cristina

doi:10.1016/j.bjid.2016.03.008

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Brazilian Journal of Infectious Diseases

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Case Report • Braz J Infect Dis 20 (4) • Jul-Aug 2016 • https://doi.org/10.1016/j.bjid.2016.03.008 copy

Secondary syphilis in the oral cavity and the role of the dental surgeon in STD prevention, diagnosis and treatment: a case series study

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Syphilis is an infectious disease caused by the bacterium Treponema pallidum. Syphilis has three clinical stages and may present various oral manifestations, mainly at the secondary stage. The disease mimics other more common oral mucosa lesions, going undiagnosed and with no proper treatment. Despite the advancements in medicine toward prevention, diagnosis, and treatment syphilis remains a public health problem worldwide. In this sense, dental surgeons should be able to identify the most common manifestations of the disease in the oral cavity, pointing to the role of this professional in prevention and diagnosis. This study describes a case series of seven patients with secondary syphilis presenting different oral manifestations.

Keywords
Oral manifestations; Secondary syphilis; Treponema pallidum

	Oral anatomical site(s) affected	Fundamental lesion	Differential diagnosis
Patient 1 Male 45 years old Married	A – Upper lip mucosa near the commissure	Ulcer and mucous plaque	Lichen planus, pemphigus vulgaris
	C – Tongue edge	Nodule and ulcer	Ulcer by trauma
	B – Lip commissure	Nodule and ulcer	Angular cheilitis

Patient 2 Male 46 years old Single	C – Hard palate	Ulcer	Spinocellular carcinoma
	A – Lower lip mucosa	Mucous plaque	Aphthous ulcer
	B – Ventral tongue	Mucous plaque	Aphthous ulcer

Patient 3 Male 42 years old Single	A/B – Bilateral tongue edge	Nodule	Trauma by biting, fibroepithelial hyperplasia

Patient 4 Female 53 years old Married	A/B – Soft palate, involving tonsil pillars	Nodule and ulcer	Spinocellular carcinoma (simultaneous)

Patient 5 Female 29 years old Long term relationship	A – Soft palate	Mucous plaque	Ulcer by trauma
	A – Hard palate	Mucous plaque	Ulcer by trauma
	B – Lower lip mucosa	Spot and erosion	Leukoplakia, lichen planus

Patient 6 Female 39 years old Married	A/B – Apex and edge of tongue, bilaterally	Mucous plaque	Pseudomembranous candidiasis, lichen planus, pemphigus vulgaris

Patient 7 Female 36 years old Long term relationship	A – Uvula and palate tonsil	Mucous plaque	Ulcer by trauma, spinocellular carcinoma

	1st assay	2nd assay	3rd assay	4th assay	5th assay
Patient 1	VDRL – positive 1:1024FTA ABS – positive	VDRL – positive 1:32FTA ABS – positive	VDRL – positive 1:2FTA ABS – positive
Patient 2	VDRL – positive 1:128FTA ABS – positive	VDRL – positive 1:32FTA ABS – positive	VDRL – positive 1:4FTA ABS – positive	VDRL – positive 1:2FTA ABS – positive	VDRL – positive 1:1FTA ABS – positive
Patient 3	VDRL – positive 1:32FTA ABS – positive	VDRL – positive 1:2FTA ABS – positive
Patient 4	VDRL – positive 1:128FTA ABS – positive	VDRL – positive 1:64FTA ABS – positive	VDRL – positive 1:16FTA ABS – positive	VDRL – positive 1:8FTA ABS – positive	VDRL – positive 1:2FTA ABS – positive
Patient 5	VDRL – positive 1:32FTA ABS – positive	VDRL – positive 1:1FTA ABS – positive
Patient 6	VDRL – positive 1:128FTA ABS – positive	VDRL – positive 1:32FTA ABS – positive	VDRL – positive 1:4FTA ABS – positive	VDRL – positive 1:2FTA ABS – positive	VDRL – positive 1:2FTA ABS – positive
Patient 7	VDRL – positive 1:16FTA ABS – positive	VDRL – positive 1:2FTA ABS – positive

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E-mail: bjid@bjid.org.br

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[1] *Corresponding author. mcmunerato@gmail.com