Figueroa-Ramos Grecia, Rodríguez-Gutiérrez Georgina, Domínguez-Cherit Judith
Secretaría de Salud, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Departamento de Dermatología. Ciudad de México, México.
Rev Med Inst Mex Seguro Soc. 2022 Oct 25;60(6):703-707.
Syphilis is an infectious disease caused by the spirochete Treponema pallidum, transmitted mainly by direct contact with the lesion. Primary syphilis usually presents with a chancre at the site of infection, which is highly contagious and resolves without treatment. The aim of this article is to illustrate an unusual location of a syphilitic chancre, in order to consider this diagnosis within the approach to patients with oral ulcers.
a 30-year-old man who presented a dermatosis located in the left labial commissure, characterized by a painless ulcer of 1 cm in diameter of 20 days of evolution. The patient has a history of HIV/AIDS. A punch biopsy of the dermatosis was performed, with a histopathological report compatible with syphilitic chancre and a negative VDRL result. He was treated with penicillin G benzathine showing improvement.
Primary syphilis is characterized by the development of the syphilitic chancre, which is the first manifestation of syphilis in up to 60% of cases. Extragenital presentation is rare, with only 12-14% of all cases, and of these between 40-70% occur in the mouth, being the lips the most frequent location. Oral manifestations can represent a diagnostic challenge due to its wide spectrum of clinical presentations.
梅毒是一种由梅毒螺旋体引起的传染病，主要通过直接接触病损传播。一期梅毒通常在感染部位出现硬下疳，其传染性很强，未经治疗也可自行消退。本文旨在阐明梅毒硬下疳的一个不寻常部位，以便在诊治口腔溃疡患者时考虑这一诊断。
一名30岁男性，其皮肤病损位于左侧口角，表现为一个直径1厘米、病程20天的无痛性溃疡。该患者有艾滋病毒/艾滋病病史。对皮肤病损进行了切取活检，组织病理学报告符合梅毒硬下疳，梅毒血清学试验（VDRL）结果为阴性。给予苄星青霉素治疗后病情好转。
一期梅毒的特征是梅毒硬下疳的出现，在高达60%的病例中，硬下疳是梅毒的首发表现。生殖器外表现罕见，在所有病例中仅占12 - 14%，其中40 - 70%发生在口腔，唇部是最常见的部位。由于口腔表现的临床谱广泛，可能构成诊断挑战。
