Division of Oral and Maxillofacial Pathology, University of Kentucky College of Dentistry, 800 Rose Street, Rm. 530, Lexington, KY, 40536, USA.
Oral and Maxillofacial Pathology Specialty Care Unit, A.T. Still University-Missouri School of Dentistry & Oral Health, St. Louis, MO, USA.
Head Neck Pathol. 2021 Sep;15(3):787-795. doi: 10.1007/s12105-020-01283-4. Epub 2021 Jan 18.
Syphilis is a sexually-transmitted infectious disease caused by Treponema pallidum. Cases of primary and secondary syphilis are on the rise in the United States, with a 14.4% increase in new cases noted from 2017 to 2018 and an escalation of 71% between the years 2014 and 2018. Fulfilling its nickname of "the great imitator," oral manifestations of syphilis may mimic a variety of infectious, neoplastic, or immune-mediated processes, both clinically and histopathologically. This large spectrum of appearances can create a diagnostic challenge to the clinician and/or pathologist, leading to delay in diagnosis or misdiagnosis.
A database of oral syphilis cases was created from archives at the University of Kentucky, University of Pittsburgh, LIJMC, Columbia University MC, and University of Tennessee. The age, sex, race, location, duration, and clinical description were recorded. Cases without positive reaction upon immunohistochemistry or serologic tests were excluded.
We identified 19 new cases of oral syphilis (17 males, one female, and one case unknown sex) and described the clinical and histopathological features of this re-emerging and potentially fatal disease. All cases demonstrated dense lymphoplasmacytic inflammation, often with inflammatory exocytosis or ulceration at the surface, and perivascular inflammation.
Early recognition of the histopathologic and clinical manifestations of oral syphilis is imperative for prompt diagnosis, improved patient outcomes, and disease prevention.
梅毒是一种由苍白密螺旋体引起的性传播感染性疾病。美国的原发性和继发性梅毒病例呈上升趋势，2017 年至 2018 年新发病例增加 14.4%，2014 年至 2018 年期间上升 71%。梅毒被称为“伟大的模仿者”，其口腔表现可能在临床和组织病理学上模仿多种感染性、肿瘤性或免疫介导性过程。这种广泛的表现形式可能给临床医生和/或病理学家带来诊断挑战，导致诊断延迟或误诊。
从肯塔基大学、匹兹堡大学、LIJMC、哥伦比亚大学 MC 和田纳西大学的档案中创建了一个口腔梅毒病例数据库。记录了年龄、性别、种族、位置、病程和临床描述。排除免疫组织化学或血清学检测结果阳性的病例。
我们确定了 19 例新的口腔梅毒病例（17 例男性，1 例女性，1 例性别未知），并描述了这种重新出现的潜在致命疾病的临床和组织病理学特征。所有病例均表现为密集的淋巴浆细胞炎症，表面常有炎症性外渗或溃疡，以及血管周围炎症。
早期认识口腔梅毒的组织病理学和临床表现对于及时诊断、改善患者预后和疾病预防至关重要。
