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ISSN 2007-3178 (Print)
Asociación Mexicana de Cirugía Bucal y Maxilofacial, Colegio Mexicano de Cirugía Bucal y Maxilofacial, A.C.

2025, Number 2

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Rev Mex Cir Bucal Maxilofac 2025; 21 (2)

Seudogranulomatous inflammation in a labial mucosal ulcer as an initial sign of secondary syphilis. Case report and narrative review

Yadira PBN, Maldonado MJ, Cano VAM, Vargas RAG

Language: Spanish
References: 33
Page: 61-70
PDF size: 2910.72 Kb.


ABSTRACT

Introduction: syphilis is an infectious disease caused by Treponema pallidum. In Mexico, its prevalence ranges from 1.7 to 13.1%, primarily among men who have sex with other men. Pseudogranulomatous inflammation is an uncommon histopathological finding in oral lesions associated with secondary syphilis, with solitary lip ulcers being the most common initial lesion of primary infection (91.7%). Objective: to present a case of secondary syphilis with an oral ulcer as the initial manifestation of the disease and with unusual clinical and histopathological characteristics, as well as to perform an updated narrative review of the literature. Case report: a 21-year-old male patient presented with a non-healing ulcer in the mucosa of the lower lip of traumatic origin. Histopathological analysis revealed an intense inflammatory infiltrate consisting of lymphocytes and plasma cells, as well as histiocyte aggregates forming pseudogranulomas and blood vessels with endarteritis. This was the first diagnostic sign of secondary syphilis. It was confirmed with the VDRL test and immunohistochemical tests for T. pallidum, both of which showed a positive result, while the HIV test was negative. The patient was treated with benzathine penicillin G and the lesion did not persist. Conclusions: the correlation of clinical, histopathological, immunohistochemical, and serological findings, along with a thorough history, led to a diagnosis of syphilis. Oral health professionals should consider the presence of sexually transmitted infections within the spectrum of oral lesions to facilitate early identification and provide appropriate treatment that ensures patient quality of life.


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