Category: Oral Pathology

Oral Manifestations of various stages of Acquired Syphilis

Dr.MehnazLeave a comment

1) PRIMARY STAGE

Development of chancre at site of inoculation. Usually Solitary in nature.

Intra-orally,

➡️ The chancre is an ulcerated lesion covered by grayish white membrane, painful due to secondary infection.

➡️ Sites:

  • Lips (Brownish crusted appearance)
  • Tongue
  • Gingiva
  • Palate
  • Tonsils
  • Fresh Extraction Wound

Microscopically:-

  • Superficial Ulcer
  • Intense inflammatory infiltrate – Plasma Cells
  • Silver Stain – Demonstration of Micro-organisms

Heals: 3 weeks – 2 months

2) SECONDARY/METASTATIC STAGE

  • 6 weeks after primary lesion
  • Diffuse eruptions on mucous membrane.
  • Multiple, painless, grayish white plaques overlying an ulcerated surface.
  • Mucous Patches:
  • Site: Tongue, Gingiva, Buccal Mucosa
  • Highly infectious
  • Appearance: Ovoid, irregular & surrounded by erythematous zone.

3) TERTIARY/LATE SYPHILIS:

  • Characterized by formation of GUMMA
  • Site: Tongue, Palate
  • Appearance: Firm, Nodular mass in the tissue; Ulcerates➡️ Deep painless ulcer
  • Lesions of Palate cause perforation by sloughing of Necrotic Mass of tissue.

ATROPHIC/INTERSTITIAL GLOSSITIS

➡️ Most characteristic & important lesion of syphilis due to endarteritis obliterans.

➡️ In syphilitic glossitis, the surface of the tongue gets broken up by fissures due to atrophy.

  • Males affected
  • Fibrosis
  • Hyperkeratosis
  • Carcinomatous transformation – Epidermoid Ca.

LEUKOPLAKIC INVOLVEMENT

White patches on tongue – Tertiary Syphilis

Due to vasculitis & endarteritis, there’s circulatory deficiency to the lingual papillae

⬇️

Atrophy of filiform & fungiform papillae

⬇️

Bald, smooth, lingual surface

⬇️

Leukoplakic involvement (Dysplastic type)

References: Shafer’sTextbook Of Oral Pathology, Image source: Google