Syphilis Diagnosis Through Oral Lesions of Different Clinical Aspects: Report of 3 Cases

DOI: https://doi.org/10.17921/2447-8938.2021v23n2p106-109
Palavras-chave: Syphilis, treponemal infections, oral manifestations
Edição: Vol. 23, N. 2 (2021)

Resumo

Syphilis is a sexually transmitted infection, caused by the anaerobic spirochete Treponema pallidum. It is characterized by a variety of clinical manifestations including the oral mucosa, mimicking several diseases, thereby making diagnosis a challenge for clinicians. Therefore, the objective of this work is to report three cases of syphilis that were diagnosed based on oral lesions of different clinical aspects. In this series of cases, the lesions were found on the tongue and hard palate and presented as white plaques, ulcers or erythematous spots associated with ulcers. In the two cases, incisional biopsy was performed, and the histopathological aspects were suggestive of syphilis. Treponemic and non-treponemic tests were positive for all the patients, confirming syphilis. Therapy with benzathine-penicillin, administered intramuscularly led to complete remission of oral lesions in all the patients. The syphilis reemergence in the last years demands its inclusion in the differential diagnosis of several oral lesions. Diagnosing syphilis by oral lesions can be difficult once it can mimic other conditions. Therefore, dentists should know the clinical aspects of this infection, since many cases may exhibit only oral manifestations, to help in the diagnosis and control of the infection spread.

Autores

Matheus Bruno Costa
Aluno de Graduação – Universidade Estadual de Londrina

Erika Terumi Tomisaki
Aluna de Graduação – Universidade Estadual de Londrina

Fabio Augusto Ito
Docente da Área de Diagnóstico Oral – Universidade Estadual de Londrina

Heliton Gustavo de Lima
Docente da Área de Estomatologia – Universidade Federal do Paraná

Willian Ricardo Pires
Docente da Área de Estomatologia – Universidade Federal do Paraná

Ademar Takahama Junior*
Docente da Área de Diagnóstico Oral – Universidade Estadual de Londrina

Referências

Brasil. Ministério da Saúde. Secretaria de vigilância em saúde. Bol Epidemiol Sífilis 2019;5(1).

de Paulo LFB, Servato JPS, Oliveira MTF, Durighetto Jr AF, Zanetta-Barbosa D. Oral manifestations of secondary syphilis. Int J Infect Dis 2015;35:40-2. doi: https://doi.org/10.1016/j.ijid.2015.04.007.

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;108:45-9. doi: https://doi.org/10.1016/j.tripleo.2009.05.013.

Kalinin Y, Neto AP, Passarelli DHC. Sífilis: aspectos clínicos, transmissão, manifestações orais, diagnóstico e tratamento. Odonto 2015;23(45-6):65-76. doi: http://dx.doi. org/10.15603/2176-1000/odonto.v23n45-46p65-76.

Valente T, Scalercio M, Israel M, Ramos ME. Diagnóstico da sífilis a partir das manifestações bucais. Rev Bras Odontol 2008;65(2):159-64. doi: http://dx.doi.org/10.18363/rbo.v65n2.p.159.

Soares AB, Gonzaga HFS, Jorge MA, Barraviera SRCS. Oral manifestations of syphilis: a review. J Venom Anim Toxins incl Trop Dis 2004;10(1):2-9. doi: http://dx.doi.org/10.1590/S1678-91992004000100002.

De Souza B. Manifestações clínicas orais da sífilis. RFO 2017;22(1):82-5. doi: https://doi.org/10.5335/rfo.v22i1.6981.

Streight KL, Paranal RM, Musher DM. The oral manifestations of syphilitic disease: a case report. J Med Case Rep 2019;13(1):227. doi: https://doi.org/10.1186/s13256-019-2171-z.

Leo JC, Gueiros LA, Porter SR. Oral manifestations of syphilis. Clinics 2006;61(2):161-6. doi: http://dx.doi.org/10.1590/S1807-59322006000200012.

Lin SW, Gao ZX, Lin LR,X, Liu LL, Yang TC. Treponema pallidum enhances human monocyte migration and invasion by dysregulating the MMP/TIMP balance. Int Immunopharmacol 2019;75:105744. doi: https://doi.org/10.1016/j.intimp.2019.105744.

Gao ZX, Luo X, Liu LL, Lin LR, Tong ML, Yang TC. Recombinant Treponema pallidum protein Tp47 induces angiogenesis by modulating the matrix metalloproteinase/tissue inhibitor of metalloproteinase balance in endothelial cells. J Eur Acad Dermatol Venereol 2019;33(10):1958-70. doi: https://doi.org/10.1111/jdv.15725.

Andrade RS, Freitas EM, Rocha BA, Gusmão ES, Filho MRM, Júnior HM. Oral findings in secondary syphilis. Med Oral Patol Oral Cir Bucal 2018;23:138-43. doi: 10.4317/medoral.22196.