Oral Manifestations of Syphilis: a Review of the Clinical and Histopathologic Characteristics of a Reemerging Entity with Report of 19 New Cases

Smith, Molly Housley; Vargo, Richard J.; Bilodeau, Elizabeth A.; Anderson, Kenneth M.; Trzcinska, Anna; Canterbury, Carleigh R.; Fantasia, John E; Rawal, Yeshwant B.

doi:10.1007/s12105-020-01283-4

Cited by 30 publications

(46 citation statements)

References 29 publications

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“…This study reports the larger series of AOS cases from South America to date, with most patients being represented by young adult men with oral manifestations of syphilis in the secondary stage at the time of diagnosis. The results are in line with previous studies (Lampros et al, 2021; Leuci et al, 2013; Matias et al, 2020; Schuch et al, 2019; Smith et al, 2021; Thums et al, 2021). The findings were also consistent across a broad spectrum of manifestations of oral syphilis, particularly in secondary‐stage infections, mimicking a variety of other diseases that affect the oral cavity (de Arruda et al, 2021; Lampros et al, 2021; Schuch et al, 2019).…”

Section: Discussionsupporting

confidence: 92%

“…Although in the current study, men were slightly more affected than women, a French series revealed a marked predilection for men, representing 95% of the survey (Lampros et al, 2021). Likewise, in a recent report by Smith and collaborators (2021), only one of the 19 individuals affected by AOS was a woman. Another study stressed that affected males are older than females (Thums et al, 2021); however, the data reported herein contrast with all of these findings.…”

Section: Discussionmentioning

confidence: 90%

“…Depending on the time elapsed after exposure to the bacteria, acquired syphilis is categorized as primary, secondary, early nonprimary nonsecondary, and late or unknown duration syphilis (Forrestel et al, 2020). The clinical manifestations of syphilis are protean and can mimic other diseases, usually showing mucocutaneous involvement, including lesions in the oral cavity (de Arruda et al, 2021; Forrestel et al, 2020; Lampros et al, 2021; Matias et al, 2020; Schuch et al, 2019; Smith et al, 2021; Thums et al, 2021). Nevertheless, diagnosing acquired syphilis through oral manifestations can be difficult and can lead to misdiagnosis or underdiagnosis (de Arruda et al, 2021; Schuch et al, 2019).…”

Section: Introductionmentioning

confidence: 99%

“…Nevertheless, diagnosing acquired syphilis through oral manifestations can be difficult and can lead to misdiagnosis or underdiagnosis (de Arruda et al, 2021; Schuch et al, 2019). Considering that the number of documented positive syphilis cases may be underestimated, about 500 cases of acquired oral syphilis (AOS) have been described in the literature (Lampros et al, 2021; Matias et al, 2020; Schuch et al, 2019; Smith et al, 2021; Thums et al, 2021). Although the largest number of reported cases of AOS came from North and South America (Matias et al, 2020; Schuch et al, 2019; Thums et al, 2021), collaborative studies are still very scarce.…”

Section: Introductionmentioning

confidence: 99%

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Acquired oral syphilis: A multicenter study of 339 patients from South America

et al. 2021

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Objective To report the clinicopathologic features of acquired oral syphilis cases in South American countries. Materials and Methods Clinical data were retrospectively collected from the records of 18 oral diagnostic services in Argentina, Brazil, Chile, Colombia, Venezuela, Uruguay, and Peru. Serologies of nontreponemal and treponemal tests were used for diagnosis. Results The series comprised 339 cases of acquired oral syphilis. Secondary syphilis ranked as the most common stage (86.7%). Lesions were more frequent among males (58.0%) and young adults with a mean age of 33.3 years. Individuals aged 20–29 years were most affected (35.3%). The most commonly involved sites were the tongue (31.6%), lip/labial commissure (25.1%), and hard/soft palate (20.4%). Clinically, acquired oral syphilis usually presented as mucous patches (28.4%), papules (25.7%), and ulcers (18.1%). Skin manifestations occurred in 67.7% of individuals, while lymphadenopathy and fever were observed in 61.3% and 11.6% of all subjects, respectively. Most patients were treated with the benzathine penicillin G antibiotic. Conclusion This report validates the spread of acquired oral syphilis infection among young adults in South America. Our directives include accessible diagnostic tools for proper disease screening, surveillance, and counselling of affected individuals, especially in low‐ and middle‐income countries.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 90%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Acquired oral syphilis: A multicenter study of 339 patients from South America

et al. 2021

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“…This is because the manifestations histologically and clinically mimic a wide variety of infectious, neoplastic and immune diseases. As a result, the diagnosis of this pathology becomes a challenge for the professional, delaying the diagnosis or missing it [30] . The infectious ulcer (chancre), the sign of the primary disease, develops after an incubation of usually 3 weeks (range 10 to 90 days) and resolves 3 to 8 weeks later [31] .…”

Section: Clinical Manifestationsmentioning

confidence: 99%

Treponema pallidum, an odontological point of view

Arizpe¹,

Magaña²,

Ruiz³

et al. 2021

Int. J. Appl. Dent. Sci.

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Introduction: Syphilis is a systemic infection of sexual, blood transfusion or transplacental transmission caused by the spirochete Treponema pallidum. Objective: To analyze the literature on the epidemiology, diagnostic methods, clinical and oral manifestations and treatment of Treponema pallidum. Methodology: A literature review was carried out in the PubMed database with the words "Treponema pallidum", together with "epidemiology", "diagnosis", "clinical manifestations", "oral manifestations" and "treatment". Results: It is estimated that each year there are 12 million new cases of syphilis worldwide and more than 90% are from developing countries. Direct detection and serological tests are the available options for identification. Infectious ulceration is the sign of primary disease, while secondary disease is characterized by multisystem involvement. Late syphilis involves neurosyphilis, cardiovascular syphilis and gummatous syphilis, which may coexist. The oral manifestation presents as one or more ulcers depending on the stage. The main treatment for syphilis is penicillin, although its effectiveness will depend on the stage of the disease. Conclusions: Due to its increasing incidence, it is of great relevance that the dentist is familiar with the clinical appearance, especially oral, of this pathology for early diagnosis and treatment.

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