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. 2020 May-Jun;86(3):358-363.
doi: 10.1016/j.bjorl.2018.12.010. Epub 2019 Feb 23.

Diagnosing acquired syphilis through oral lesions: the 12 year experience of an Oral Medicine Center

Michelle Danielle Porto Matias  1 , Alessandro Oliveira de Jesus  1 , Renata Gonçalves Resende  2 , Patrícia Carlos Caldeira  1 , Maria Cássia Ferreira de Aguiar  3
Affiliations

Diagnosing acquired syphilis through oral lesions: the 12 year experience of an Oral Medicine Center

Michelle Danielle Porto Matias et al. Braz J Otorhinolaryngol. 2020 May-Jun.

Abstract
in English, Portuguese

Introduction: A resurgence of syphilis in Brazil has been reported in recent years.

Objective: With this in mind, the present study sought to investigate the frequency, demographics, and clinical characteristics of patients with acquired syphilis with oral involvement who received medical care at an Oral Medicine Reference Center in a Brazilian Public Hospital.

Methods: A retrospective study, spanning a period of 12 years, was performed to identify changing trends in syphilis over time. Medical records from all patients diagnosed with acquired syphilis who received medical care at the Hospital's Oral Medicine Clinic from 2005 to 2016 were reviewed, and the demographic and clinical data were collected.

Results: A total of 85 patients had been diagnosed with acquired syphilis, with a significant increase in the number of cases over the past 5 years. Patients ranged from 16 to 76 years of age, with a peak in the third and fourth decades. Forty-eight cases affected males (56.5%), while 37 cases affected females (43.5%). Most of the oral lesions appeared as unique ulcers or plaques, with the lips and tongue representing the most affected sites. All cases were positive for Venereal Disease Research Laboratory or Fluorescent Treponemal Antibody Absorption, and treatment was performed with Penicillin G benzathine in most cases (84.7%).

Conclusion: The frequency of oral syphilis has been rising over time and oral lesions may well represent a diagnostic clue; therefore, oral health professionals must be made aware and properly trained in an attempt to develop a high degree of clinical suspicion in the diagnosis of syphilis.

Introdução: Um ressurgimento da sífilis no Brasil tem sido relatado nos últimos anos.

Objetivo: Investigar frequência, as características demográficas e clínicas dos pacientes com sífilis adquirida com envolvimento oral que receberam atendimento médico em um centro de referência em medicina oral em um hospital público brasileiro.

Método: Estudo retrospectivo, abrangeu 12 anos, feito para identificar tendências de mudança na sífilis. Registros médicos de todos os pacientes diagnosticados com sífilis adquirida que receberam atendimento médico na clínica de medicina oral do hospital de 2005 a 2016 foram revisados e os dados demográficos e clínicos foram coletados.

Resultados: Foram diagnosticas 85 pacientes com sífilis adquirida, com um aumento significativo no número de casos nos últimos 5 anos. A idade dos pacientes variou de 16 a 76 anos, com pico na terceira e quarta décadas. 48 casos eram do sexo masculino (56,5%) e 37 do sexo feminino (43,5%). A maioria das lesões orais apareceu como úlceras ou placas únicas, os lábios e a língua representaram os locais mais afetados. Todos os casos foram positivos para Venereal Disease Research Laboratory e Fluorescent Treponemal Antibody Absorption Test e o tratamento foi feito com penicilina G benzatina na maioria dos casos (84,7%).

Conclusão: A frequência da sífilis oral tem aumentado com o tempo e as lesões orais podem representar uma pista diagnóstica; portanto, os profissionais de saúde bucal devem ser conscientizados e devidamente treinados na tentativa de desenvolver um alto grau de suspeição clínica no diagnóstico da sífilis.

Keywords: Diagnosis; Diagnóstico; Epidemiologia; Epidemiology; Infecção por sífilis; Lesões orais; Oral lesions; Syphilis infection.

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Figures

Figure 1
Figure 1
Number of cases diagnosed as acquired syphilis with oral manifestations between 2005 and 2016 at the Oral Medicine Service – HMOB.
Figure 2
Figure 2
Annual frequency distribution of acquired syphilis with oral manifestations according to patient's sex.
Figure 3
Figure 3
Frequency distribution of acquired syphilis with oral manifestations between 2005 and 2016 according to sex and age.
Figure 4
Figure 4
Oral syphilis represented by multiple (A) and single (B) ulcer and mucous plaque.
See this image and copyright information in PMC

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