ORAL PATHOLOGY

Oral Pathology Associated With Syphilis

Abstract

A representative case is presented here for better understanding. We wish to highlight the resurgence of this disease, which has occurred recently in the western world, particularly in Europe and the United States of America. Since the initial presentation may be oral, it is important to include syphilis in the differential diagnosis of patients presenting to oral diagnostic clinics with atypical oral ulceration. Recent developments in the serological diagnostic tests and treatment are reviewed. Early diagnosis and treatment has significant implications, not only for the patient, but also for previous and future transmission to contacts. Early syphilis is a highly infectious disease in which the lesions heal spontaneously, despite inappropriate treatment which may appear curative, and yet the patient remains infectious. It is therefore important that clinicians maintain a high clinical index of suspicion and crucial that an accurate diagnosis be made at presentation.

Oral Pathology Associated With Syphilis

Introduction

Syphilis is an acute and chronic sexually transmitted disease (STD) caused by Treponema pallidum that produces skin and mucous membrane lesions in the acute phase.1 In the chronic phase, bone, viscera, cardiovascular, and neurological disease are produced. The variety of systemic manifestations associated with the later stages of syphilis resulted in its being historically designated as the “great imitator” disease. (Alam, 2009)

The vast majority of cases are transmitted sexually, although it may also be transmitted vertically from an infected woman to her newborn child. Both genital and oral sex are implicated in the transmission of syphilis. As with gonorrhea, humans are the only known natural host for syphilis. The primary site of syphilitic infection is the genitalia, although primary lesions also occur extra genitally. Syphilis remains an important infection in contemporary medicine because of the morbidity it causes and its ability to enhance the transmission of human immunodeficiency virus (HIV).

Discussion

Here I am going to explain a case study as 24-year-old female with an indurated, painless, ulcer of 8 weeks standing. The lesion had been much larger and was in the spontaneous healing phase. The patient was identified by contact tracing, following the diagnosis of genital syphilis in a previous male heterosexual partner. She was otherwise asymptomatic. There was no lymphadenopathy and she was afebrile. Chest X-ray, microbiological, immunological and haematological testing were non-contributory. The lesion was not biopsied Her treponemal serology confirmed primary disease (positive FTA IgM and FTA IgG). She was also counseled for ...