The Great Imitator: Primary Syphilis Clinically Mimicking Oral Squamous Cell Carcinoma

Magnaterra, Elisabetta; Grandi, Vieri; Pisano, L

doi:10.1016/j.amjmed.2022.02.029

Cited by 3 publications

(2 citation statements)

References 5 publications

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“…A tissue biopsy confirmed primary syphilis rather than carcinoma [7]. Similar mass-like presentations causing clinical concern for neoplasia have been reported in other anatomic sites, including the stomach and oral cavity [8][9]. Finally, patients who present with the classic painless genital chancre of primary syphilis may receive testing for STIs; however, up to one-third of perianal syphilitic lesions may be painful.…”

Section: Discussionmentioning

confidence: 62%

Painful Anal Ulcers in an HIV-Negative Young Woman: An Atypical Presentation of Syphilis

Kroeker,

Lopez,

Castellon

et al. 2023

Cureus

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Section: Discussionmentioning

confidence: 62%

Painful Anal Ulcers in an HIV-Negative Young Woman: An Atypical Presentation of Syphilis

Kroeker,

Lopez,

Castellon

et al. 2023

Cureus

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“…However, beyond many case report [ 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 ] and narrative review [ 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 ] syphilis manifestations, very few studies and/or case series including more than five cases with atypical syphilis manifestations have been published in the English literature during the past 20 years [ 32 , 33 , 34 , 35 , 36 , 37 , 38 ] ( Table 4 ). Cases of atypical primary syphilis misdiagnosed as pharyngeal lymphoma, tongue cancer, and other types of oral squamous cell carcinomas have been described [ 39 , 40 , 41 ]; however, the secondary stage of the disease, given the possible involvement of the whole skin area and of other organs, is the one that is most prone to misdiagnosis like palmoplantar psoriasis, psoriasis vulgaris, erythema multiforme, cutaneous lymphoma, and granulomatous diseases of the skin (annular granuloma, sarcoidosis). Moreover, involvement of internal organs with signs and symptoms of osteomyelitis, nephrotic syndrome, retinitis, and others has been reported in secondary syphilis with or without typical cutaneous/mucosal involvement, further complicating the clinical picture [ 42 , 43 , 44 , 45 , 46 , 47 ].…”

Section: Discussionmentioning

confidence: 99%

Atypical Manifestations of Syphilis: A 10-Year Retrospective Study

Ciccarese,

Facciorusso,

Mastrolonardo

et al. 2024

JCM

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Background: The incidence of syphilis has increased in high-income countries in the past few decades, especially among men who have sex with men. In the present study, we aimed to analyze the correlations between atypical syphilis manifestations and the demographic, clinical, and laboratory features of patients and to review unusual presentations of syphilis reported in the literature. Methods: We conducted a retrospective analysis of 307 patients with syphilis diagnosed between 1 January 2013 and 31 October 2023 at the sexually transmitted infection (STI) centers of the University of Genoa and University of Foggia with both typical and atypical manifestations of disease. Results: In our series, atypical manifestations were detected in 25.8% of the patients, especially in the secondary stage of the disease. Lesions with annular morphology and lesions presenting as itchy erythematous scaly plaques with a psoriasiform appearance were the most common atypical presentations of secondary syphilis. A statistical analysis revealed that homosexual orientation, syphilis reinfection, and venereal disease research laboratory (VDRL) titers > 1:32 were correlated with atypical manifestations. Conclusions: Our study demonstrates that the spectrum of syphilis manifestations, in all the stages of the disease, is wide; atypical manifestations often pose diagnostic challenges, may delay the provision of appropriate treatment, and facilitate the spread of the infection.

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The Mucosal Manifestations of Syphilis in the Head and Neck

Khan¹,

Sharma²,

Hathorn³

et al. 2023

Ear Nose Throat J

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Objectives: Syphilis is a resurging disease which can present itself in many ways, including lesions within the head and neck mucosa. Some of these lesions may clinically mimic oral malignancies. This literature review aims to better characterize the mucosal presentations of syphilis. Methods: PubMed, EMBASE, and clinicaltrials.gov were searched for full-text, English articles published from 1950 to 2022 that reported patients with head and neck mucosal manifestations of syphilis. Articles were screened according to PRISMA guidelines. Results: One hundred forty-three manuscripts documenting 236 individual patients were included in the review. Patients with secondary syphilis accounted for 62% of patients presenting with head and neck mucosal lesions. The most common lesions found in primary and secondary syphilis were ulcerations, primarily found on the tongue, lips, and palate. While serologic studies are the gold standard for diagnosing syphilis, biopsy of these lesions have characteristic syphilitic changes. Conclusions: Syphilis’ nickname of “The great imitator” remains to be true, and the head and neck mucosal manifestations of this disease can resemble commonly seen malignancies. Awareness of this disease and its lesions is prudent given the rising incidence of syphilis within the United States.

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The Great Imitator: Primary Syphilis Clinically Mimicking Oral Squamous Cell Carcinoma

Cited by 3 publications

References 5 publications

Painful Anal Ulcers in an HIV-Negative Young Woman: An Atypical Presentation of Syphilis

Painful Anal Ulcers in an HIV-Negative Young Woman: An Atypical Presentation of Syphilis

Atypical Manifestations of Syphilis: A 10-Year Retrospective Study

The Mucosal Manifestations of Syphilis in the Head and Neck

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