International Journal of Oral and Maxillofacial Surgery
Clinical PaperClinical PathologyDiagnostic approaches in unsuspected oral lesions of syphilis
Section snippets
Materials and methods
All cases diagnosed with a chronic inflammatory process and for whom the possibility of syphilis was noted on the diagnosis report, were retrieved from the archives of the university oral pathology department; these records were from a period of 5 years (2005–2010). The study was approved by the university ethics committee. A total of 39 cases were retrieved. Haematoxylin and eosin (H&E) stained slides were reviewed to confirm the histological hypothesis of syphilis, and tissue specimens from
Results
A total of 18 out of the 39 cases retrieved were positive for the anti-T. pallidum antibody. According to information obtained subsequently from the contributors, these 18 cases had tested positive for syphilis at the time of the diagnosis and had been diagnosed with secondary syphilis. None of the remaining 21 cases tested positive. Thus, the 18 positive cases represented patients with unsuspected lesions of secondary syphilis who had received diverse differential diagnoses before the biopsy.
Discussion
Although syphilis is an old disease, it is now considered a re-emerging disease, especially in the West, where it is estimated that there are 10 to 12 million new cases each year.13 The present study showed that many clinicians do not consider syphilis in their differential diagnosis of oral lesions. The variable characteristics of these lesions (white, ulcerated, elevated, single or multiple) lead to different diagnostic hypotheses, such as lichen planus, bullous pemphigoid, squamous cell
Funding
Funded by CAPES (Coordenação de Aperfeiçoamento de Pessoal de Nível Superior – National Council for the Improvement of Higher Education).
Competing interests
There is no conflict of interest.
Ethical approval
The study was approved by the Ethics Committee in Research ofthe University of São Paulo, School of Dentistry, São Paulo, Brazil (Protocol 35/11 CAAE 0035.0.017.000-11).
Patient consent
Just intra buccal images are listed. Patient consent was obtained to print the intraoral photographs.
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