Leuci S, Martina S, Adamo D, Ruoppo E, Santarelli A, Sorrentino R, Favia G, Mignogna Md
Department of Odontostomatological and Maxillo Facial Sciences, Oral Medicine Unit, Federico II University of Naples, Naples, Italy.
Oral Dis. 2013 Nov;19(8):738-46. doi: 10.1111/odi.12058. Epub 2013 Jan 7.
To present a retrospective analysis of multicentre case series of oral syphilis and a review of relevant literature.
A PUBMED search was carried out from 1950 to 2011. Clinical records of patients with exclusive/prevalent oral manifestations of syphilis were collected and examined in three independent hospitals.
Of 23 reports describing 34 patients were detected through the review (35% primary, 56% secondary, and 9% tertiary disease), describing unspecific ulcers (59%), mucosal patches (23%), keratosis (6%), pseudomembranes (3%), and gumma (9%). Multicentre case series revealed 12 patients with oral syphilis, of which 17%, 58%, and 25% with, respectively, primary, secondary, and tertiary lesions. Clinically, patients showed white patches (17%), blistering mucositis (8%), chronic unspecific ulcers with/without skin lesions (50%), gumma (17%), and necrosis of the dorsum of the tongue (8%). Oral bullae and tongue necrosis are never described in the current review.
Diagnosis of syphilis remains a challenge because of the multiform and polymorphous clinical pattern at onset and its ability to imitate different diseases. It is mandatory to include syphilis in the differential diagnosis of unusual oral lesions. Diagnosis of oral lesions of syphilis is often difficult, and biopsy is required in controversial cases.
对口腔梅毒多中心病例系列进行回顾性分析，并对相关文献进行综述。
在1950年至2011年间进行了PubMed检索。收集并检查了三家独立医院中梅毒仅表现为口腔症状/或主要表现为口腔症状患者的临床记录。
通过综述发现23篇报告描述了34例患者（35%为一期梅毒，56%为二期梅毒，9%为三期梅毒），描述了非特异性溃疡（59%）、黏膜斑（23%）、角化病（6%）、假膜（3%）和树胶肿（9%）。多中心病例系列显示12例口腔梅毒患者，其中17%、58%和25%分别为一期、二期和三期病变。临床上，患者表现为白色斑块（17%）、水疱性黏膜炎（8%）、伴有/不伴有皮肤病变的慢性非特异性溃疡（50%）、树胶肿（17%）和舌背坏死（8%）。本综述中未提及口腔大疱和舌坏死。
由于梅毒发病初期临床表现多样且具有模仿不同疾病的能力，梅毒的诊断仍然是一项挑战。在不寻常口腔病变的鉴别诊断中必须考虑梅毒。梅毒口腔病变的诊断往往困难，在有争议的病例中需要进行活检。
