口腔粘膜炎を契機に診断された梅毒の2例

梅毒

北海道歯学会

北海道歯学雑誌

Syphilis is an infectious disease caused by Treponema pallidum that has an increasing incidence in Japan. Syphilis sometimes presents as ulcers called hard chancres in the oral cavity and lips. We report two cases of syphilis presenting as hard chancres.　Patient 1 was a woman in her 30s with ulcers on the vulva and u pper lip. Although she had visited her gynecologist and dentist, her symptoms remained unchanged. Therefore, she presented at our department. At the first visit, she had ulcers on the tongue and upper lip and bilateral painful subman dibular masses, each with a diameter of approximately 10 mm.. Serological testing revealed positive results for both the rapid plasma reagin (RPR) test and the T. pallidum hemagglutination assay (TPLA) test. Therefore, she was referred to the dermatology departmen t in our hospital with suspected syphilitic stomatitis. After receiving Amoxicillin/clavulanic acid 1125mg/day and Amoxicillin 750mg/day antibiotics for 6 weeks under a diagnosis of syphilis, her symptoms had completely resolved.　Patient 2 was a woman in her 40s with ulcers on the right buccal mucosa and lower lip and swelling of the right submandibular region. Despite visiting her dentist, dermatologi st, and otorhinolaryngologist, her symptoms remained unchanged. Therefore, she presented at our department. At the first visit, she had ulcers on both sides of her lower lip and right buccal mucosa, and a painless mass with a diameter of 30 mm in her right submandibular region. Serological testing revealed positive results for both the RPR test and the TPLA test. Therefore, she was referred to the dermatology department with suspected syphilitic stomatitis and syphilitic lymphadenitis. She received Amoxicillin 1500 mg/day 4 weeks of antibiotics under a diagnosis of syphilis, wh ich resulted in a reduction in the number of ulcers in the size of her ulcers. After receiving antibiotics for a total of 8 weeks, her symptoms were completely resolved.　Dentists need to consider syphilis as a differential diagnosis in patients with intractable ulcers and cervical lymphadenopathy of unknown etiology. Moreover, it is important to perform an appropriate medical interview, perform tests and examinations, and engage in multidisciplinary collaboration to treat these intractable conditions.