NUMERO: #20250527

Título: ORAL MUCOUS PLAQUES IN SECONDARY SYPHILIS: KEY IN DIAGNOSING PERSISTENT ORAL LESIONS

Nome do Apresentador: Suse Barbosa CASTILHO

Categoria do Trabalho: Painel de caso clínico (PCC)

Área Temática: Odontologia hospitalar

Resumo: A 28-year-old male presented with painful lip ulcers persisting for 2 months, unresponsive to acyclovir and topical aphthous spray. He had a 10-year smoking history, past homelessness, and ongoing chemical rehabilitation. Examination revealed heterogeneous leukoplakic plaques (2 cm upper lip, 1 cm lower lip) with erythematous areas and superficial ulceration, flaccid on palpation. Initial suspicion of infectious etiology was positive to syphilis by VDRL (1:64) and FTA-ABS and negative to HIV/hepatitis serologies. Histopathology showed ulcerated lesion with intraepithelial microabscesses and dense submucosal plasma cell infiltrates. Special stains (PAS, Grocott, Warthin-Starry, Ziehl-Neelsen) and immunohistochemistry to Treponema pallidum were performed. The clinical feature confirmed secondary syphilis diagnosis. Treatment with benzathine penicillin G (2.4 million IU weekly for 3 weeks) led to complete resolution in 10 days. No recurrence occurred during 9-month follow-up. This case highlights the importance of considering syphilis in persistent oral mucous plaques, especially in high-risk populations.

Autor 1:  Suse Barbosa CASTILHO

E-mail 1:  [email protected]

Autor 2:   Nara Rúbia Pereira de SIQUEIRA

E-mail 2:  [email protected]

Autor 3 :  Jailton Gomes Amâncio da SILVA

E-mail 3:  [email protected]

Autor 4:  Eneida Franco VENCIO

E-mail 4:  [email protected]

Autor 5:  Rejane Faria RIBEIRO-ROTTA

E-mail 5:  [email protected]