Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2009 Sep;3(3):195-206.
doi: 10.1007/s12105-009-0127-0. Epub 2009 Jul 22.

Syphilis: the renaissance of an old disease with oral implications

Giuseppe Ficarra  1 , Roman Carlos
Affiliations
Review

Syphilis: the renaissance of an old disease with oral implications

Giuseppe Ficarra et al. Head Neck Pathol. 2009 Sep.

Abstract

Syphilis is caused by Treponema pallidum an anaerobic filamentous spirochete. In recent years, striking outbreaks have occurred in USA, Canada, Russia, China and some areas of Central and Eastern Europe. Main epidemiology changes reflect sex industry, sexual promiscuity, decreasing use of barrier protection (i.e. condoms) due to false sense of security that nowadays sexually transmitted diseases are curable and lack of pertinent knowledge. Considering that the initial presentation of syphilis may be the oral cavity, it is of great relevance to include this disease in the differential diagnosis of unusual oral ulcerations and white patches. Primary syphilis is a highly infectious disease in which inappropriate treatment may be apparently curative while the patient remains highly infectious. It is then of pivotal importance that clinicians maintain a high clinical index of suspicion. At the present time, clinical-pathologic correlation together with serologic studies remain essential in establishing the diagnosis of syphilis.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
Secondary syphilis: maculopapular skin lesions of the neck
Fig. 2
Fig. 2
Secondary syphilis: maculopapular and scaly lesions of the plantar area
Fig. 3
Fig. 3
Moth-eaten alopecia in secondary syphilis
Fig. 4
Fig. 4
Macerated plaques (condylomata lata) of the toe webs
Fig. 5
Fig. 5
Ulceronodular skin lesion of lue maligna
Fig. 6
Fig. 6
Oral chancre in a promiscuous woman who had unprotected oral sex
Fig. 7
Fig. 7
Secondary oral syphilis: mucous patches covered by grayish, white pseudomembranes of the lower vestibular mucosa
Fig. 8
Fig. 8
Secondary oral syphilis with lesions on the soft palate. The patient also had pharyngitis and laryngitis
Fig. 9
Fig. 9
Perioral fissuring (rhagades) in a 3 year-old patient with congenital syphilis
Fig. 10
Fig. 10
Silver stain of syphilis showing the corkscrew-shaped treponemes (×40)
Fig. 11
Fig. 11
Immunohistochemical method: the spirochetes are visible in the lower epithelial lamina (×40)
Fig. 12
Fig. 12
Secondary oral syphilis. Plasma cell, along with lymphocytes and macrophages are visible as a band-like infiltrate in the lamina propria and with a perivascular distribution (EE, ×20)
Fig. 13
Fig. 13
Secondary oral syphilis. A perineural and perivascular plasmacellular infiltrate is visible in the deep lamina propria (EE, ×40)
See this image and copyright information in PMC

References

    1. Hook EW, III, Marra CM. Acquired syphilis in adults. New Engl J Med. 1992;326:1060–1068. - PubMed
    1. Tramont EC. Treponema pallidum (syphilis) In: Mandell GL, Benett JF, Dolin R, editors. Principles and practice of infectious diseases. 6. Orlando, FL: Churchill Livingstone; 2005. pp. 2768–2784.
    1. Sanchez MR. Syphilis. In: Wolff K, Goldsmith LA, Katz SI, Gilchrest BA, Paller AS, Leffell DJ, editors. Fitzpatrick’s dermatology in general medicine. 7. New York: Mc Graw Hill; 2008. pp. 1955–1977.
    1. Tramont EC. Syphilis in adults: from Christopher Columbus to Sir Alexander Fleming to AIDS. Clin Infect Dis. 1995;21:1361–1369. - PubMed
    1. Zimmer C. Isolated tribe gives clues to the origins of syphilis. Science. 2008;319:272. doi: 10.1126/science.319.5861.272. - DOI - PubMed