Portal de Periódicos da CAPES

Condylomata lata of the oral commissure: an unexpected presentation of secondary syphilis

2021; Elsevier BV; Volume: 27; Issue: 5 Linguagem: Inglês

10.1016/j.mpdhp.2021.02.007

1756-2317

Luke Farmkiss, Vincent Shadrick, Tim Bracey,

Reproductive tract infections research

We present the case of a 33 year-old male presenting with a white lesion within the left oral commissure. The lesion was initially regarded as either smoker's keratosis or verrucous hyperplasia and was biopsied to exclude a neoplasm. Histology revealed squamous epithelial hyperplasia, plasmacytic inflammation and neuritis. Treponema immunohistochemistry demonstrated the presence of spirochetes and subsequent serology confirmed the diagnosis as syphilis. The oral commissure is an unusual site for secondary syphilis (condylomata lata). The clinical resemblance of condylomata lata to other oral cavity lesions may lead to biopsy, as it did in this case. This presents a diagnostic challenge for pathologists since the features of syphilis are non-specific. Associated features that raise suspicion include: epithelial hyperplasia; granulomatous inflammation; endarteritis; and florid plasma cell inflammation with neuritis. Morphology should be corroborated with immunohistochemistry and serological testing. Prompt communication with clinical colleagues facilitates timely treatment and contact tracing.