title: Clinical Spectrum of Oral Secondary Syphilis in HIV-Infected Patients.
abstract: Background. Oral lesions may constitute the first clinical manifestation in secondary syphilis, but detailed descriptions in HIV-infected individuals are scarce. Objective. To describe the clinical characteristics of oral secondary syphilis in HIV-infected patients and its relevance in the early diagnosis of syphilis. Methods. Twenty HIV/AIDS adult subjects with oral secondary syphilis lesions presenting at two HIV/AIDS referral centers in Mexico City (2003-2011) are described. An oral examination was performed by specialists in oral pathology and medicine; when possible, a punch biopsy was done, and Warthin-Starry stain and immunohistochemistry were completed. Intraoral herpes virus infection and erythematous candidosis were ruled out by cytological analysis. Diagnosis of oral syphilis was confirmed with positive nontreponemal test (VDRL), and, if possible, fluorescent treponemal antibody test. Results. Twenty male patients (median age 31.5, 21-59 years) with oral secondary syphilis lesions were included. Oral lesions were the first clinical sign of syphilis in 16 (80%) cases. Mucous patch was the most common oral manifestation (17, 85.5%), followed by shallow ulcers (2, 10%) and macular lesions (1, 5%). Conclusions. Due to the recent rise in HIV-syphilis coinfection, dental and medical practitioners should consider secondary syphilis in the differential diagnosis of oral lesions, particularly in HIV-infected patients.
authors: Departamento de Atención a la Salud, Universidad Autónoma Metropolitana, 04960 Ciudad de México, Mexico.
authors: Velia
authors: V
authors: Ramírez-Amador
authors: Departamento de Atención a la Salud, Universidad Autónoma Metropolitana, 04960 Ciudad de México, Mexico.
authors: Gabriela
authors: G
authors: Anaya-Saavedra
authors: Clínica de VIH/SIDA, Departamento de Infectología, Instituto Nacional de Ciencias Médicas y Nutrición "Salvador Zubirán", 14000 Ciudad de México, Mexico.
authors: Brenda
authors: B
authors: Crabtree-Ramírez
authors: Departamento de Dermatología, Instituto Nacional de Ciencias Médicas y Nutrición "Salvador Zubirán", 14000 Ciudad de México, Mexico.
authors: Lilly
authors: L
authors: Esquivel-Pedraza
authors: Departamento de Patología, Instituto Nacional de Ciencias Médicas y Nutrición "Salvador Zubirán", 14000 Ciudad de México, Mexico.
authors: Marcela
authors: M
authors: Saeb-Lima
authors: Clínica de VIH/SIDA, Departamento de Infectología, Instituto Nacional de Ciencias Médicas y Nutrición "Salvador Zubirán", 14000 Ciudad de México, Mexico.
authors: Juan
authors: J
authors: Sierra-Madero