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[Primary syphilis with initial lower-lip sclerosis--a case report].

Go Omura1, Osamu Fukuoka, Masami Suzuki

  • 1Department of Head and Neck Surgery, Saitama Medical University International Medical Center, Hidaka.

Nihon Jibiinkoka Gakkai Kaiho
|October 20, 2010
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This case highlights primary syphilis presenting as a lower-lip lesion. Effective treatment with amoxicillin led to lesion resolution and negative serological tests, emphasizing lip syphilis recognition in outpatient settings.

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Area of Science:

  • Dermatology
  • Infectious Diseases
  • Public Health

Background:

  • Syphilis, a sexually transmitted infection caused by *Treponema pallidum*, typically presents with distinct stages.
  • Primary syphilis commonly manifests as a genital or anal chancre, but extragenital lesions can occur.
  • Lip chancres are rare but important presentations of primary syphilis.

Observation:

  • A 54-year-old male presented with a lesion on his lower lip.
  • Serological testing revealed elevated results for Syphilis-Rapid Plasma Regain (STS-RPR) and Treponema Pallidum Lipid Antigen (TPLA).
  • The patient was diagnosed with primary syphilis based on clinical presentation and serological findings.

Findings:

  • Treatment with amoxicillin at 1500 mg/day for four weeks resulted in near complete resolution of the lip lesion.
  • Serological markers (STS-RPR and TPLA) returned to negative levels within six months of initiating antibiotic therapy.
  • The case demonstrates a successful treatment outcome for primary lip syphilis.

Implications:

  • This case emphasizes the importance of considering syphilis in the differential diagnosis of lower-lip lesions, even in primary care settings.
  • Early recognition and appropriate treatment of primary syphilis, regardless of lesion location, are crucial to prevent disease progression and transmission.
  • Healthcare providers should maintain a high index of suspicion for extragenital syphilis presentations.