Oral manifestations of syphilis: an epidemiological study in southern Brazil

Abstract

Background Syphilis is an infectious, sexually transmitted disease with varied oral manifestations, that can mimic other lesions. This study aimed to conduct an epidemiological survey of cases of syphilis, diagnosed from oral manifestations, establishing the sociodemographic profile of patients and clinical characteristics of oral lesions. Methods The medical records of patients with oral lesions of syphilis acquired were reviewed, and 109 cases were selected. Results The mean age of the patients was 34.4 years and, of these, 51% were male. In 105 cases, the disease was diagnosed in the secondary stage; in three cases, in the primary stage; and, in one case, in the tertiary stage. The cases of primary syphilis presented as single and ulcerated nodules, and the case of tertiary syphilis, as a necrotic lesion in the palate. In 86% of cases of secondary syphilis, there were multicentric lesions, presenting as grayish‐white plaques (85%), associated or not with erosive and/or ulcerated lesions (33%), mostly affecting the labial mucosa and tongue. In 91.7% of cases painful symptoms were reported. Conclusion Considering the increase in syphilis, it is extremely important that dentists recognize its oral manifestations, because early diagnosis and treatment can minimize the risks of complications and transmission.

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

“…This study reports the larger series of AOS cases from South America to date, with most patients being represented by young adult men with oral manifestations of syphilis in the secondary stage at the time of diagnosis. The results are in line with previous studies (Lampros et al, 2021;Leuci et al, 2013;Matias et al, 2020;Schuch et al, 2019;Smith et al, 2021;Thums et al, 2021).…”

“…However, about 60% of cases occurred in patients in the third and fourth decades of life, as also previously reported (Schuch et al, 2019;Thums et al, 2021). Interestingly, adolescents were equally affected in terms of the number of cases compared with individuals in their 40s and 50s.…”

“…Depending on the time elapsed after exposure to the bacteria, acquired syphilis is categorized as primary, secondary, early nonprimary nonsecondary, and late or unknown duration syphilis (Forrestel et al, 2020). The clinical manifestations of syphilis are protean and can mimic other diseases, usually showing mucocutaneous involvement, including lesions in the oral cavity (de Arruda et al, 2021;Forrestel et al, 2020;Lampros et al, 2021;Matias et al, 2020;Schuch et al, 2019;Smith et al, 2021;Thums et al, 2021).…”

“…Nevertheless, diagnosing acquired syphilis through oral manifestations can be difficult and can lead to misdiagnosis or underdiagnosis (de Arruda et al, 2021;Schuch et al, 2019). Considering that the number of documented positive syphilis cases may be underestimated, about 500 cases of acquired oral syphilis (AOS) have been described in the literature (Lampros et al, 2021;Matias et al, 2020;Schuch et al, 2019;Smith et al, 2021;Thums et al, 2021). Although the largest number of reported cases of AOS came from North and South America (Matias et al, 2020;Schuch et al, 2019;Thums et al, 2021), collaborative studies are still very scarce.…”

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

“…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.…”