Syphilis

Syphilis (also known as Lues venerea) is an infective pathology, which is caused by a bacterium (Treponema pallidum). It is mainly transmitted sexually and is chronic; 3 phases can be distinguished:
1. Primary syphilis presents after 1-3 weeks of contact with the bacterium, a raised lesion with an erosion or ulcerated centre. It occasionally exudes serum and/or bleeds, it is asymptomatic and the bacterium is the typical point of contact (chancre or primary syphilis).
There is also localised lymphadenopathy, which is not painful. The micro-organism causing primary syphilis will be located in the oral mucosa (tongue, lip, hard and soft palate, buccal mucosa) and/or genital or anal mucosa).
2.Secondary syphilis occurs 4-6 weeks after the appearance of syphiloma: secreting ulcers (similar to the secretions of the nail) can appear on the oral mucosa as well as whitish-reddish, raised plaques (on occasion fissured) on the labial mucosa and tongue and in the labial commissure of the mouth. There can also be wart-like lesions in the genitalia and anal region (known as condyloma latum). The patient will: not feel very well, suffer from fever with a macular-papular skin rash (Biett’s collarette, with its peripheral hyperkeratosis of the palm-plantar lesions, is pathognomonic), have alopecia and widespread but not painful lymphadenopathy with hard but loose lymph nodes.
3.Tertiary syphilis presents late, after one year of contagion; in the absence of antibiotic treatment the patient will alternate between phases of remission and latency. Clinical symptoms can vary: nodular lesions result in a destructive ulcer on the palate and the tongue (gummas), interstitial glossitis, syphilitic leukoplakia, cardio-vascular complications and trigeminal neuropathies.
Congenital syphilis – rarely encountered – occurs in children. Pathognomonically, it appears as Hutchinson’s triad: malformed teeth (incisors with semilunar margins and mulberry molars), interstitial keratitis and acoustic nerve deafness (eighth nerve).