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References

Public Health England. Tracking the syphilis epidemic in England: 2010 to 2019. 2021. https://tinyurl.com/2vh79t3k (accessed August 2022)
Thompson LDR Oral Syphilis. Ear Nose Throat J. 2021; 100:538S-539S https://doi.org/10.1177/0145561319890154
Public Health England. New STI diagnoses and rates by gender, sexual risk, age group and ethnic group, 2015 to 2019. 2019. http://www.gov.uk/government/statistics/sexually-transmitted-infections-stis-annual-data-tables (accessed January 2021)
Thakrar P, Aclimandos W, Goldmeier D, Setterfield JF Oral ulcers as a presentation of secondary syphilis. Clin Exp Dermatol. 2018; 43:868-875 https://doi.org/10.1111/ced.13640
Kingston M, French P, Higgins S UK national guidelines on the management of syphilis 2015. Int J STD AIDS. 2016; 27:421-446 https://doi.org/10.1177/0956462415624059
Lynn WA, Lightman S Syphilis and HIV: a dangerous combination. Lancet Infect Dis. 2004; 4:456-466 https://doi.org/10.1016/S1473-3099(04)01061-8
Matias MDP, Jesus AO, Resende RG Diagnosing acquired syphilis through oral lesions: the 12 year experience of an oral medicine center. Braz J Otorhinolaryngol. 2020; 86:358-363 https://doi.org/10.1016/j.bjorl.2018.12.010
Seibt CE, Munerato MC Secondary syphilis in the oral cavity and the role of the dental surgeon in STD prevention, diagnosis and treatment: a case series study. Braz J Infect Dis. 2016; 20:393-398 https://doi.org/10.1016/j.bjid.2016.03.008
Zhang W, Mao Q, Lyu X Diagnosis of oral syphilis remains a challenge. A case report. Int J Infect Dis. 2020; 99:231-232 https://doi.org/10.1016/j.ijid.2020.07.049
O'Byrne P, MacPherson P Syphilis. BMJ. 2019; 365 https://doi.org/10.1136/bmj.l4159
de Arruda JAA, do Valle IB, Mesquita RA, Silva TA Oral syphilis. J Am Acad Dermatol. 2021; 84:e101-e102 https://doi.org/10.1016/j.jaad.2020.09.067
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Streight KL, Paranal RM, Musher DM The oral manifestations of syphilitic disease: a case report. J Med Case Rep. 2019; 13 https://doi.org/10.1186/s13256-019-2171-z
Thakrar P, Aclimandos W, Goldmeier D, Setterfield JF Oral ulcers as a presentation of secondary syphilis. Clin Exp Dermatol. 2018; 43:868-875 https://doi.org/10.1111/ced.13640
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Müller H, Eisendle K, Bräuninger W Comparative analysis of immunohistochemistry, polymerase chain reaction and focus-floating microscopy for the detection of Treponema pallidum in mucocutaneous lesions of primary, secondary and tertiary syphilis. Br J Dermatol. 2011; 165:50-60 https://doi.org/10.1111/j.1365-2133.2011.10314.x

Syphilis: The great imitator

From Volume 49, Issue 9, October 2022 | Pages 738-740

Authors

Elizabeth Offen

BDS MFDS RCS (Eng), Unit of Oral and Maxillofacial Surgery, Rotherham NHS Foundation Trust

Articles by Elizabeth Offen

Email Elizabeth Offen

Syed Ali Khurram

BDS, MSc, PhD, MFDS RCS (Ed), CiLT, FHEA, FRC Path, Unit of Oral and Maxillofacial Pathology, School of Clinical Dentistry, University of Sheffield

Articles by Syed Ali Khurram

Manjinderpal Jandu

BChD, MBBS, FDSRCS (Eng), MRCS (Eng), FRCS (OMFS), Unit of Oral and Maxillofacial Surgery, Rotherham NHS Foundation Trust

Articles by Manjinderpal Jandu

Abstract

The rates of syphilis in the UK are rising. Syphilis is a bacterial sexually transmitted infection caused by Treponema pallidum. If left untreated, it can have serious health implications. Diagnosing syphilis remains a challenge due to its diverse spectrum of clinical presentations. Oral manifestations can present in the primary, secondary and tertiary stages of the disease. Therefore, dental professionals are well positioned to detect the signs. This article reviews the stages of the disease, its oral manifestations, and conditions that syphilis may mimic. A case report of a patient presenting in the primary stage of the disease is discussed.

CPD/Clinical Relevance: Dental professionals should be able to identify the oral signs of syphilis because prompt referral in the early stages of disease can prevent long-term syphilitic complications.

Article

Syphilis is a contagious bacterial infection caused by the Treponema pallidum spirochete. It can be acquired or congenital.

The UK has experienced a resurgence in syphilis rates over the past decade.1,2 In 2019, 7982 new cases of syphilis were diagnosed in the UK, marking the highest incidence since the 1940s.1 London, Brighton and Manchester experienced the greatest increase in prevalence.

Between 2015 and 2019, the rate of syphilis diagnoses rose by 50%.3 The cohort of 25–34 year old men who have sex with men (MSM) showed the greatest increase in cases,3,4 and 40% of those diagnosed with syphilis had concurrent HIV infection,5 which is not surprising as syphilis is known to facilitate HIV acquisition and transmission.6 The oral cavity is the most commonly affected extragenital site for primary syphilis.7

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