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Oral syphilis: report of three cases and characterization of the inflammatory cells.
Ann Diagn Pathol. 2015 Apr; 19(2):76-80.AD

Abstract

Syphilis is a sexually transmitted infectious disease caused by Treponema pallidum. This study reports 3 cases of syphilis and highlights the importance of identifying oral lesions for its final diagnosis. Case 1: a 48-year-old male patient presented with a bleeding ulcer in the lower lip. Overall clinical examination revealed patchy alopecia and skin target lesions. Case 2: a 61-year-old male patient presented with white spots on the lateral tongue and nodules on the dorsum of the tongue. Overall clinical examination showed erythematous target lesions on the abdomen, forearm, palms of the hand, and soles of the feet. Case 3: a 17-year-old male patient presented with an ulcerated lesion on the tongue and lymph node involvement. The following serologic tests were requested: Venereal Disease Research Laboratory, fluorescent treponemal antibody-absorption, anti-HIV-1 and anti-HIV-2, and anti-hepatitis C virus. An incisional biopsy revealed epithelial hyperplasia associated with intense and diffuse mononuclear inflammatory cell infiltration consisting mainly of plasma cells, in a perivascular and perineural distribution. The final diagnosis in the 3 patients was syphilis. Treatment consisted of 1 weekly dose of penicillin (2.4 million units, intramuscular) for 2 or 3 weeks. Immunohistochemical reactions for XIIIa, CD3, CD20, CD68, CD163, S100, CD1a, CD11c, CD83, CD138, and CD208 were performed. Clinicians should be familiarized with oral syphilis lesions in order to be able to diagnose this emerging infectious disease of variable clinical presentation.

Authors+Show Affiliations

Science and Technology Institute, University of São Paulo State, São José dos Campos, São Paulo, Brazil. Electronic address: lucianastrieder@hotmail.com.Discipline of Oral Pathology, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil. Electronic address: jleon@forp.usp.br.Department of Biopathology and Oral Diagnosis, Science and Technology Institute, University of São Paulo State, São José dos Campos, São Paulo, Brazil. Electronic address: yasmin@fosjc.unesp.br.Discipline of Stomatology, Science and Technology Institute, University of São Paulo State, São José dos Campos, São Paulo, Brazil. Electronic address: estela@fosjc.unesp.br.

Pub Type(s)

Case Reports
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

25736987

Citation

Strieder, Luciana Rocha, et al. "Oral Syphilis: Report of Three Cases and Characterization of the Inflammatory Cells." Annals of Diagnostic Pathology, vol. 19, no. 2, 2015, pp. 76-80.
Strieder LR, León JE, Carvalho YR, et al. Oral syphilis: report of three cases and characterization of the inflammatory cells. Ann Diagn Pathol. 2015;19(2):76-80.
Strieder, L. R., León, J. E., Carvalho, Y. R., & Kaminagakura, E. (2015). Oral syphilis: report of three cases and characterization of the inflammatory cells. Annals of Diagnostic Pathology, 19(2), 76-80. https://doi.org/10.1016/j.anndiagpath.2015.01.003
Strieder LR, et al. Oral Syphilis: Report of Three Cases and Characterization of the Inflammatory Cells. Ann Diagn Pathol. 2015;19(2):76-80. PubMed PMID: 25736987.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Oral syphilis: report of three cases and characterization of the inflammatory cells. AU - Strieder,Luciana Rocha, AU - León,Jorge Esquiche, AU - Carvalho,Yasmin Rodarte, AU - Kaminagakura,Estela, Y1 - 2015/01/15/ PY - 2014/09/25/received PY - 2015/01/09/accepted PY - 2015/3/5/entrez PY - 2015/3/5/pubmed PY - 2015/12/15/medline KW - Infection disease KW - Sexually transmitted diseases KW - Treponema pallidum SP - 76 EP - 80 JF - Annals of diagnostic pathology JO - Ann Diagn Pathol VL - 19 IS - 2 N2 - Syphilis is a sexually transmitted infectious disease caused by Treponema pallidum. This study reports 3 cases of syphilis and highlights the importance of identifying oral lesions for its final diagnosis. Case 1: a 48-year-old male patient presented with a bleeding ulcer in the lower lip. Overall clinical examination revealed patchy alopecia and skin target lesions. Case 2: a 61-year-old male patient presented with white spots on the lateral tongue and nodules on the dorsum of the tongue. Overall clinical examination showed erythematous target lesions on the abdomen, forearm, palms of the hand, and soles of the feet. Case 3: a 17-year-old male patient presented with an ulcerated lesion on the tongue and lymph node involvement. The following serologic tests were requested: Venereal Disease Research Laboratory, fluorescent treponemal antibody-absorption, anti-HIV-1 and anti-HIV-2, and anti-hepatitis C virus. An incisional biopsy revealed epithelial hyperplasia associated with intense and diffuse mononuclear inflammatory cell infiltration consisting mainly of plasma cells, in a perivascular and perineural distribution. The final diagnosis in the 3 patients was syphilis. Treatment consisted of 1 weekly dose of penicillin (2.4 million units, intramuscular) for 2 or 3 weeks. Immunohistochemical reactions for XIIIa, CD3, CD20, CD68, CD163, S100, CD1a, CD11c, CD83, CD138, and CD208 were performed. Clinicians should be familiarized with oral syphilis lesions in order to be able to diagnose this emerging infectious disease of variable clinical presentation. SN - 1532-8198 UR - https://www.unboundmedicine.com/medline/citation/25736987/Oral_syphilis:_report_of_three_cases_and_characterization_of_the_inflammatory_cells_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1092-9134(15)00004-0 DB - PRIME DP - Unbound Medicine ER -