Diagnosing acquired syphilis through oral lesions: the 12 year experience of an Oral Medicine Center

Abstract Introduction: A resurgence of syphilis in Brazil has been reported in recent years. Objective: With this in mind, the present study sought to investigate the frequency, demographics, and clinical characteristics of patients with acquired syphilis with oral involvement who received medical care at an Oral Medicine Reference Center in a Brazilian Public Hospital. Methods: A retrospective study, spanning a period of 12 years, was performed to identify changing trends in syphilis over time. Medical records from all patients diagnosed with acquired syphilis who received medical care at the Hospital's Oral Medicine Clinic from 2005 to 2016 were reviewed, and the demographic and clinical data were collected. Results: A total of 85 patients had been diagnosed with acquired syphilis, with a significant increase in the number of cases over the past 5 years. Patients ranged from 16 to 76 years of age, with a peak in the third and fourth decades. Forty-eight cases affected males (56.5%), while 37 cases affected females (43.5%). Most of the oral lesions appeared as unique ulcers or plaques, with the lips and tongue representing the most affected sites. All cases were positive for Venereal Disease Research Laboratory or Fluorescent Treponemal Antibody Absorption, and treatment was performed with Penicillin G benzathine in most cases (84.7%). Conclusion: The frequency of oral syphilis has been rising over time and oral lesions may well represent a diagnostic clue; therefore, oral health professionals must be made aware and properly trained in an attempt to develop a high degree of clinical suspicion in the diagnosis of syphilis.

摘要与引言：近年来，巴西有梅毒疫情反弹的报道。
研究目的：鉴于此，本研究旨在调查巴西某公立医院口腔医学参考中心（Oral Medicine Reference Center）收治的伴口腔受累的获得性梅毒（acquired syphilis）患者的发病频率、人口统计学特征及临床特点。
研究方法：本研究为一项为期12年的回顾性研究，旨在分析梅毒发病随时间的变化趋势。我们回顾了2005年至2016年间于该医院口腔医学专科门诊就诊、确诊为获得性梅毒的所有患者的病历资料，并收集其人口统计学与临床数据。
研究结果：共计85例患者被诊断为获得性梅毒，且近5年病例数呈显著增长趋势。患者年龄介于16至76岁之间，发病高峰集中于30~49岁年龄段。其中男性48例（占比56.5%），女性37例（占比43.5%）。多数口腔损害表现为单发溃疡或斑块，唇部与舌部为最常受累的部位。所有患者的性病研究实验室试验（Venereal Disease Research Laboratory, VDRL）或荧光密螺旋体抗体吸收试验（Fluorescent Treponemal Antibody Absorption, FTA-ABS）结果均为阳性，且多数患者（84.7%）接受了苄星青霉素G（Penicillin G benzathine）治疗。
研究结论：口腔梅毒的发病频率随时间呈上升趋势，口腔损害可作为重要的诊断线索；因此，口腔医疗卫生人员需接受相关培训，以提升梅毒诊断的临床警觉性。