title: Syphilis related to atypical oral lesions affecting an elderly man. a case report.
abstract: OBJECTIVE
  To present a case of oral syphilis in an old patient.
  
  
  BACKGROUND
  Syphilis seems to be resurging mainly in the young. However, in the last twenty years, the elderly have become more susceptive to infectious diseases due to a more frequent use of sildenafil.
  
  
  METHODS
  An 83-year-old man was referred to our clinic complaining of burning mouth. His medical history revealed papular lesions on chest and penis glans, which had been diagnosed and treated as scabiosis 2 months prior to our assessment. The intra-oral examination showed erosive and patch lesions on the bilateral lip commissures, the palate and the border of the tongue. Initially, oral herpes was suspected. However, both the serological test and the cytology were negative. Therefore, syphilis was hypothesised. Non-treponemic (VDRL) and treponemic tests (FTA-ABS) were reagent and secondary syphilis was confirmed. The treatment consisted of penicillin G benzathine 2.4 million IU/IM for 4 weeks. Both oral and skin lesions had complete remission.
  
  
  CONCLUSIONS
  The present case illustrates that syphilis should be suspected in old patients with oral atypical lesions.
authors.affiliation: Stomatology Department, Hospital AC Camargo, São Paulo, Brazil.
authors.forename: Juliane Piragine
authors.initials: JP
authors.lastname: Araujo
authors.forename: Graziella Chagas
authors.initials: GC
authors.lastname: Jaguar
authors.forename: Fabio Abreu
authors.initials: FA
authors.lastname: Alves
mesh_terms: D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use; D002308:Cardiolipins; D002784:Cholesterol; D003951:Diagnostic Errors / Q000517:prevention & control; D007172:Erectile Dysfunction / Q000188:drug therapy; D016508:Fluorescent Treponemal Antibody-Absorption Test; D006801:Humans; D007306:Insecticides / Q000627:therapeutic use; D007559:Ivermectin / Q000627:therapeutic use; D008297:Male; D009055:Mouth / Q000473:pathology*; D010401:Penicillin G Benzathine / Q000008:administration & dosage / Q000627:therapeutic use; D010713:Phosphatidylcholines; D012532:Scabies / Q000175:diagnosis* / Q000188:drug therapy; D000068677:Sildenafil Citrate / Q000627:therapeutic use; D013283:Stomatitis, Herpetic / Q000097:blood / Q000175:diagnosis*; D013587:Syphilis / Q000097:blood / Q000175:diagnosis* / Q000188:drug therapy; D047568:Unsafe Sex; D064804:Urological Agents / Q000627:therapeutic use
chemical_list: D000900:Anti-Bacterial Agents; D002308:Cardiolipins; D007306:Insecticides; D010713:Phosphatidylcholines; D064804:Urological Agents; C054448:VDRL antigen; D007559:Ivermectin; D002784:Cholesterol; D000068677:Sildenafil Citrate; D010401:Penicillin G Benzathine
keywords: oral diseases; oral lesions; oral syphilis; syphilis