與二級梅毒相關口腔潰瘍的診斷與治療：四例報告
Secondary Syphilis-Related Oral Ulcers and AIDS: Report of Four Cases

 
盧心玉    邢福柳
高雄長庚紀念醫院 家庭牙醫學科 病理科

     
         Establishing a diagnosis of syphilis, whenever the stage of the disease, can be difficult because syphilis is a great mimic in clinical morphology and histology. Many patients infected with venereal diseases have oral manifestations, but very few dentists and physicians have the proper experience to diagnose syphilis or other sexually transmitted diseases (STDs) from oral lesions. Oral secondary syphilis appears to be very uncommon, and few cases have been reported over the recent past. We present 4 patients who developed secondary syphilis-related oral lesions of moist ulcers, irregular linear erosions termed 'snail-track' ulcers, or erythematous mucous patch on the labial mucosa, buccal mucosa, palate or tongue. Concurrent HIV infection was diagnosed in 1 patient. The histological examination in 2 patients showed dense subepithelial inflammatory cell infiltration comprised predominantly of plasma cells, and it was of practical help in the diagnosis of syphilis. The diagnostic value of a histologic examination, serologic tests, and treatment of syphilis were discussed. Obviously, co-infection with HIV will complicate the clinical presentation, diagnosis, and management of syphilis. It is highlighted that concurrent HIV infection should be considered in any patient with a sexually transmitted disease including syphilis.