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INDIAN DENTAL ACADEMY
Leader in continuing Dental Education
www.indiandentalacademy.com
Syphilis is an acute and chronic sexually transmitted
disease (STD) caused by spirochete Treponema pallidum
that produces ...
•The oral cavity is the most common extra genital
site of syphilis infection. Oral lesions in secondary
stage syphilis are...
www.indiandentalacademy.com
www.indiandentalacademy.com
www.indiandentalacademy.com
www.indiandentalacademy.com
www.indiandentalacademy.com
www.indiandentalacademy.com
www.indiandentalacademy.com
Pemphigus vulgaris
www.indiandentalacademy.com
•BULLOUS PEMPHIGOID
•CICATRICIAL PEMPHIGOID
•ERYTHEMA MULTIFORME
www.indiandentalacademy.com
Hb%: 16.2% Polymorphs:58%
Hematocrit:45.0% Lymphocytes:34%
MCV:88.4 Eosinophils:07%
MCH:31.8 Basophils:0
MCHC:36.0 ESR:24
...
•Overlying epidermis is moderately
hyperplastic and keratinized, focally
ulcerated and covered with exudate.
•There is den...
•VDRL TEST
•TPHA TEST
•ELISA TEST FOR HIV
www.indiandentalacademy.com
SECONDARY SYPHILITIC LESIONS
INVOLVING BUCCAL AND LABIAL MUCOSA
www.indiandentalacademy.com
www.indiandentalacademy.com
www.indiandentalacademy.com
The name syphilis was coined by Italian physician
and poet Girolamo Fracastoro in his epic noted
poem, written in latin , ...
• Syphilis is caused by Treponema pallidum, a
spirochete, and is characterized by episodes of
active disease interrupted b...
•High rates of tuberculosis, HBV and syphilis
among HIV infected persons are reported.
Mahajan A et al
•Prevalence of syph...
•In the past, there was a male predominance of 3.5:1
but at present the male to female ratio is approximately
1:1 due to e...
• Syphilis can be classified as either congenital or
acquired which can be primary, secondary, latent
and tertiary , depen...
• The secondary stage, usually commencing about six
to eight weeks after primary lesion is characterized by
fever, arthral...
•The oral lesions arise in at least 30% of patients
with secondary syphilis and rarely oral ulceration
may be only manifes...
•Mucous membrane lesions tends to be oval- to-
crescentric erosions or shallow ulcers of about 1 cm
diameter, covered by a...
Non-treponemal serologic test are
#Venereal Disease Research Laboratory (VDRL)
#Rapid Plasma Reagin (RPR)
Treponemal serol...
•Plasma cell infiltration is the key microscopic
features in primary and secondary disease and
perivascular infiltrate wit...
•The current medical management of syphilis
includes the use of long acting Benzathine
penicillinG,2.4 million units intra...
Prevalence of sexually transmitted diseases apparently are
far higher in developing countries because of lack of
awareness...
THANK
YOU
www.indiandentalacademy.com
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Oral Ulceration/ dental implant courses

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The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.

Published in: Education
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Oral Ulceration/ dental implant courses

  1. 1. INDIAN DENTAL ACADEMY Leader in continuing Dental Education www.indiandentalacademy.com
  2. 2. Syphilis is an acute and chronic sexually transmitted disease (STD) caused by spirochete Treponema pallidum that produces skin and mucous membrane lesions . www.indiandentalacademy.com
  3. 3. •The oral cavity is the most common extra genital site of syphilis infection. Oral lesions in secondary stage syphilis are particularly common when associated with general symptoms and cutaneous eruption. •However, the exclusive oral localization, not associated with general manifestations, is uncommon. We report a case of oral ulceration as the sole presentation of secondary syphilis. www.indiandentalacademy.com
  4. 4. www.indiandentalacademy.com
  5. 5. www.indiandentalacademy.com
  6. 6. www.indiandentalacademy.com
  7. 7. www.indiandentalacademy.com
  8. 8. www.indiandentalacademy.com
  9. 9. www.indiandentalacademy.com
  10. 10. www.indiandentalacademy.com
  11. 11. Pemphigus vulgaris www.indiandentalacademy.com
  12. 12. •BULLOUS PEMPHIGOID •CICATRICIAL PEMPHIGOID •ERYTHEMA MULTIFORME www.indiandentalacademy.com
  13. 13. Hb%: 16.2% Polymorphs:58% Hematocrit:45.0% Lymphocytes:34% MCV:88.4 Eosinophils:07% MCH:31.8 Basophils:0 MCHC:36.0 ESR:24 BT : 3.10 CT:5.45 Total leucocyte count:8,000 cu/mm www.indiandentalacademy.com
  14. 14. •Overlying epidermis is moderately hyperplastic and keratinized, focally ulcerated and covered with exudate. •There is dense dermal and conspicuously perivascular (both in superficial and deep dermis) plasma cell lymphoplasmacytic infiltrate present with an ill defined collection of histiocytes and perineural infiltrate also noted. www.indiandentalacademy.com
  15. 15. •VDRL TEST •TPHA TEST •ELISA TEST FOR HIV www.indiandentalacademy.com
  16. 16. SECONDARY SYPHILITIC LESIONS INVOLVING BUCCAL AND LABIAL MUCOSA www.indiandentalacademy.com
  17. 17. www.indiandentalacademy.com
  18. 18. www.indiandentalacademy.com
  19. 19. The name syphilis was coined by Italian physician and poet Girolamo Fracastoro in his epic noted poem, written in latin , entitled “Syphilis sive morbus glallicus” (Latin for “Syphilis or the French disease”) in 1530. www.indiandentalacademy.com
  20. 20. • Syphilis is caused by Treponema pallidum, a spirochete, and is characterized by episodes of active disease interrupted by the period of latency. •This is a gram positive, motile, slender, fragile, microcephalic spirochete is pathogenic to humans demonstrated by the dark field microscope with a fresh specimen. www.indiandentalacademy.com
  21. 21. •High rates of tuberculosis, HBV and syphilis among HIV infected persons are reported. Mahajan A et al •Prevalence of syphilis was highest (22%) sexually transmitted infections among sex workers Thakor H.G et al. www.indiandentalacademy.com
  22. 22. •In the past, there was a male predominance of 3.5:1 but at present the male to female ratio is approximately 1:1 due to elevated rates of syphilis among women involved in prostitution related to crack cocaine. •Transmission occurs via oral-genital, oral-anal, or other sexual contact with contaminated material, and intra-uterine transmission. Soares A.B et al www.indiandentalacademy.com
  23. 23. • Syphilis can be classified as either congenital or acquired which can be primary, secondary, latent and tertiary , depending on the elapsed time after exposure. www.indiandentalacademy.com
  24. 24. • The secondary stage, usually commencing about six to eight weeks after primary lesion is characterized by fever, arthralgia, malaise and generalized eruptions of the skin and mucous membranes. www.indiandentalacademy.com
  25. 25. •The oral lesions arise in at least 30% of patients with secondary syphilis and rarely oral ulceration may be only manifestation of infection with the absence of skin lesions. Leao J.C et al www.indiandentalacademy.com
  26. 26. •Mucous membrane lesions tends to be oval- to- crescentric erosions or shallow ulcers of about 1 cm diameter, covered by a grey mucoid exudates and with an erythematous border. •The patches usually arise bilaterally on the mobile surfaces of mouth, although the pharynx, gingiva, tonsils, and very rarely the hard palate can be affected. Leao J.C et al www.indiandentalacademy.com
  27. 27. Non-treponemal serologic test are #Venereal Disease Research Laboratory (VDRL) #Rapid Plasma Reagin (RPR) Treponemal serologic tests are #Fluorescent Treponemal Antibody absorption (FTA- ABS), #Treponema Pallidum Haemagglutination Assay (TPHA) #Enzyme immunoassay (EIA). www.indiandentalacademy.com
  28. 28. •Plasma cell infiltration is the key microscopic features in primary and secondary disease and perivascular infiltrate with a preponderance of plasma cells are, however , common in oral biopsies which extends deeply into sub mucosa that should perhaps bring the diagnosis to mind. Barrett A.W et al www.indiandentalacademy.com
  29. 29. •The current medical management of syphilis includes the use of long acting Benzathine penicillinG,2.4 million units intramuscularly in single dose. • Alternate drugs for patients include oral doxycycline or tetracycline. James W Little www.indiandentalacademy.com
  30. 30. Prevalence of sexually transmitted diseases apparently are far higher in developing countries because of lack of awareness and treatment is less accessible. Syphilitic lesion is prone to be misdiagnosed therefore it should be considered under the differential diagnosis of “chronic, multiple, recurrent, shallow, ulcerative and scrapable white lesions with erythematous border”. www.indiandentalacademy.com
  31. 31. THANK YOU www.indiandentalacademy.com

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