Acquired oral syphilis: A multicenter study of 339 patients from South America

Abstract

Objective To report the clinicopathologic features of acquired oral syphilis cases in South American countries. Materials and Methods Clinical data were retrospectively collected from the records of 18 oral diagnostic services in Argentina, Brazil, Chile, Colombia, Venezuela, Uruguay, and Peru. Serologies of nontreponemal and treponemal tests were used for diagnosis. Results The series comprised 339 cases of acquired oral syphilis. Secondary syphilis ranked as the most common stage (86.7%). Lesions were more frequent among males (58.0%) and young adults with a mean age of 33.3 years. Individuals aged 20–29 years were most affected (35.3%). The most commonly involved sites were the tongue (31.6%), lip/labial commissure (25.1%), and hard/soft palate (20.4%). Clinically, acquired oral syphilis usually presented as mucous patches (28.4%), papules (25.7%), and ulcers (18.1%). Skin manifestations occurred in 67.7% of individuals, while lymphadenopathy and fever were observed in 61.3% and 11.6% of all subjects, respectively. Most patients were treated with the benzathine penicillin G antibiotic. Conclusion This report validates the spread of acquired oral syphilis infection among young adults in South America. Our directives include accessible diagnostic tools for proper disease screening, surveillance, and counselling of affected individuals, especially in low‐ and middle‐income countries.

Acquired Oral Syphilis Guidelines for Dental Practitioners: Two Case Studies and A Literature Review

“…It is generally accepted that more males are diagnosed with syphilis than females [4], [6], [31], [114], [115] with a peak in the third and fourth decades of life (age groups 20-29 years and 30-39 years). The mean age of males is also higher as compared to that of females [4], [6], [31], [114], [115]. A case series from the files of [4] included 24 males (60%, mean age 36.4 years) and 16 (40%, mean age 35.3 years) females.…”

“…In their retrospective study, [6] mainly described oral lesions as single (96.5%) ulcerations (79%), and that those lesions usually presented as mucosal plaques when they appeared at multiple sites (p < 0.05). Another retrospective study by de [115] reported that acquired oral syphilis usually presented as mucous patches (28.4%), papules (25.7%) or ulcers (18.1%). A single anatomical site was involved in 87% cases of primary syphilis, while 50.5% of the cases involved one anatomical site, 21% affected two sites, and 8% affected three or more sites in cases of secondary syphilis.…”

Impact of data scarcity on the evaluation of risk factors associated with acquired oral syphilis in South America

“…4 While much consideration has been given to the high rates among men and a large proportion of cases affecting men who have sex with men (MSM), especially those HIV-positive, increased trends among women have also been highlighted. 5,6 However, risk factors associated with the disease are barely explored in studies reporting cases of individuals with AOS. Recently, we reported 339 cases of AOS identified at 18 referral services from seven South American countries.…”

“…Recently, we reported 339 cases of AOS identified at 18 referral services from seven South American countries. 6 Of note, information regarding risk factors was available in only 25% of cases (e.g. drug abuse, whether the individual had multiple sexual partners, and whether the individual was a sex worker or an MSM) in the records, even being the study a retrospective analysis.…”

“…drug abuse, whether the individual had multiple sexual partners, and whether the individual was a sex worker or an MSM) in the records, even being the study a retrospective analysis. 6 Likewise, Thums et al 7 documented the cases of 109 individuals with oral manifestations of syphilis in Brazil, but no data on the risk factors were reported. The overall information observed in other South American series is very much similar.…”