Oral syphilis in Argentina: a cross-sectional study showing clinical and serological features

To describe the demographic, clinical, and serological characteristics of patients diagnosed with syphilis based on oral manifestations at the Department of Oral Medicine, Facultad de Odontología, Universidad Nacional de Córdoba, Argentina. A concise review of the current literature addressing oral manifestations of syphilis is also provided to categorize oral findings.

A retrospective, observational study (2010-2023) was conducted. Medical records of patients diagnosed with syphilis through oral lesions were analyzed. Variables included demographic data, syphilis stage at diagnosis, oral lesion characteristics, and serological findings. Diagnosis was confirmed through clinical-serological criteria based on CDC guidelines.

A total of 131 patients were included, with a mean age of 34.48 years (14-71). Regarding sex distribution, 46% were males and 54% females. Secondary syphilis was the most frequent stage (91%), with multifocal oral lesions predominating (75%). Diagnosis was predominantly serological (98.5%). Histopathological examination was used in only 1.5% of cases. The most affected sites were the tongue (84.7%). Mucosal plaques, tongue depapillation, and red/white patches and macules were common findings. A significant association was found between VDRL titers and general lymph nodes involvement (P = .013).

Oral syphilis presents with diverse clinical manifestations, often mimicking other diseases. Its increasing incidence highlights the need for dental professionals to recognize its features for early diagnosis and management. Additionally, the standardization of the nomenclature for oral lesions, as we have developed in this study, plays a relevant role in improving diagnostic accuracy.