Ramirez-Amador V, Madero J G, Pedraza L E, de la Rosa Garcia E, Guevara M G, Gutierrez E R, Reyes-Teran G
Health Care Department, Universidad Autonoma Metropolitana-Xochimilco.
Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1996 Jun;81(6):652-4. doi: 10.1016/s1079-2104(96)80070-9.
This report describes a case of secondary syphilis in a patient with the human immunodeficiency virus (HIV) in whom the main clinical presentation of the disease was an extensive oral lesion. Few reports in the literature have focused on oral manifestations of syphilis in HIV-infected patients; most of these reports have dealt with a rare manifestation of secondary syphilis, the ulceronodular variety or lues maligna. However, in the case reported here the lesions were painless, smooth, white, oral plaques and papules on an erythematous base with a serpentine and reddish outline corresponding to the description of mucous patches. The differential diagnosis of this lesion may include oral squamous carcinoma, leukoplakia, erythroleukoplakia, candidosis, lichen planus, and granulomatous diseases. This case report emphasizes the importance of considering secondary syphilis in the differential diagnosis of oral lesions in HIV-infected patients, reinforces the importance of follow-up on the patient, and highlights the consideration for routine serologic testing for syphilis in all HIV-infected patients.
本报告描述了一例感染人类免疫缺陷病毒（HIV）的二期梅毒患者，该疾病的主要临床表现为广泛的口腔病变。文献中很少有报告关注HIV感染患者梅毒的口腔表现；这些报告大多涉及二期梅毒的罕见表现，即溃疡结节型或恶性梅毒。然而，在本报告的病例中，病变为无痛性、光滑、白色的口腔斑块和丘疹，基底呈红斑状，有蜿蜒的红色边缘，符合黏膜斑的描述。该病变的鉴别诊断可能包括口腔鳞状癌、白斑、红白斑、念珠菌病、扁平苔藓和肉芽肿性疾病。本病例报告强调了在HIV感染患者口腔病变的鉴别诊断中考虑二期梅毒的重要性，强化了对患者进行随访的重要性，并突出了对所有HIV感染患者进行梅毒常规血清学检测的必要性。
