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Resurgence of syphilis: a diagnosis based on unusual oral mucosa lesions.

Abstract

BACKGROUND

Known as "the great imitator," secondary syphilis may clinically manifest itself in myriad of ways, involving different organs (including the oral cavity), and mimicking, both clinically and histologically, several diseases, thereby making diagnosis a challenge for clinicians.

CASE REPORT

We highlight an interesting case of a 45-year-old man on whose diagnosis of secondary syphilis was based on the presence of unusual oral lesions, consisting of a well delimited, raised, nonhomogeneous, and corrugated white plaque on the right buccal mucosa which mimicked, clinically and histologically, a "leukoplakia-like" plaque and several whitish oral mucous patches localized on the lower labial mucosa and the right lateral margin of the tongue. After the oral lesions, the patient developed a symmetric maculopapular cutaneous rash on the palms, soles, and the trunk of the body. Furthermore, during the anamnesis the patient stated an asymptomatic ulcerative lesion on the glans penis, which had appeared 7 months before the onset of the oral lesions and spontaneously disappeared after 2 weeks. The history of these genital and cutaneous lesions suggested performing serologic tests for syphilis, revealing strongly positive titers and leading us to making a diagnosis of secondary syphilis.

CONCLUSION

This case is remarkable because it displays an unusual oral sign, associated with secondary syphilis; in fact, only occasionally does syphilis manifest itself with a "leukoplakia-like" plaque. Dentists should consider secondary syphilis in the differential diagnosis of white and/or ulcerative oral lesions, above all in at-risk patients, given the continuing rise of syphilis in western Europe.

Authors+Show Affiliations

Department Oral Sciences, Section of Oral Medicine, University of Palermo, Palermo, Italy. compilato@odonto.unipa.itNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

19716491

Citation

Compilato, Domenico, et al. "Resurgence of Syphilis: a Diagnosis Based On Unusual Oral Mucosa Lesions." Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontics, vol. 108, no. 3, 2009, pp. e45-9.
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.
Compilato, D., Amato, S., & Campisi, G. (2009). Resurgence of syphilis: a diagnosis based on unusual oral mucosa lesions. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontics, 108(3), e45-9. https://doi.org/10.1016/j.tripleo.2009.05.013
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. PubMed PMID: 19716491.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Resurgence of syphilis: a diagnosis based on unusual oral mucosa lesions. AU - Compilato,Domenico, AU - Amato,Salvatore, AU - Campisi,Giuseppina, PY - 2009/03/12/received PY - 2009/05/07/revised PY - 2009/05/09/accepted PY - 2009/9/1/entrez PY - 2009/9/1/pubmed PY - 2009/12/16/medline SP - e45 EP - 9 JF - Oral surgery, oral medicine, oral pathology, oral radiology, and endodontics JO - Oral Surg Oral Med Oral Pathol Oral Radiol Endod VL - 108 IS - 3 N2 - BACKGROUND: Known as "the great imitator," secondary syphilis may clinically manifest itself in myriad of ways, involving different organs (including the oral cavity), and mimicking, both clinically and histologically, several diseases, thereby making diagnosis a challenge for clinicians. CASE REPORT: We highlight an interesting case of a 45-year-old man on whose diagnosis of secondary syphilis was based on the presence of unusual oral lesions, consisting of a well delimited, raised, nonhomogeneous, and corrugated white plaque on the right buccal mucosa which mimicked, clinically and histologically, a "leukoplakia-like" plaque and several whitish oral mucous patches localized on the lower labial mucosa and the right lateral margin of the tongue. After the oral lesions, the patient developed a symmetric maculopapular cutaneous rash on the palms, soles, and the trunk of the body. Furthermore, during the anamnesis the patient stated an asymptomatic ulcerative lesion on the glans penis, which had appeared 7 months before the onset of the oral lesions and spontaneously disappeared after 2 weeks. The history of these genital and cutaneous lesions suggested performing serologic tests for syphilis, revealing strongly positive titers and leading us to making a diagnosis of secondary syphilis. CONCLUSION: This case is remarkable because it displays an unusual oral sign, associated with secondary syphilis; in fact, only occasionally does syphilis manifest itself with a "leukoplakia-like" plaque. Dentists should consider secondary syphilis in the differential diagnosis of white and/or ulcerative oral lesions, above all in at-risk patients, given the continuing rise of syphilis in western Europe. SN - 1528-395X UR - https://www.unboundmedicine.com/medline/citation/19716491/Resurgence_of_syphilis:_a_diagnosis_based_on_unusual_oral_mucosa_lesions_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1079-2104(09)00374-6 DB - PRIME DP - Unbound Medicine ER -