PATHOGNOMIC MANIFESTATIONS OF SECONDARY SYPHILIS ON ORAL MUCOSA AND LIPS: CLINICAL CASES

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Secondary syphilids on oral mucosa and lips are acute contagious; in addition, they are quite often the only clinical manifestation of the syphilis. Therefore the recognition of oral mucosal syphilids is an important, high-priority task. Purpose. To consider the peculiarities and clinical variants of oral mucosal syphilids, what may occur by usual examinations of patients. Material and methods. We observed 36 patients with secondary syphilis, who have syphilids on the oral mucosa or lips. It is presented 12 characteristic cases. The complex serodiagnostic tests for syphilis and HIV and clinical examination of all patients were maked. Results. The oral mucosal syphilids in hall cases (39-71%; p = 0.05), especially by recidive syphilis, were presented the MILIARY “point-papules” or “streak-papules” which grouped in the form of a “seed-pearls strings and rings”. The photographing is handy for their detection. Mucosal PLAQUES and lenticular papules are “delicate” (non-hard), opaline. They are marked but they accounted for little more of half of mucosal eruptions (50-81%; p = 0.05). Besides they were in ⅓ cases with miliary papules combined. Mucosal plaques are focal arranged or else they closely grouped (phenomenon “pseudo confluence”). Imaginary confluenсe of plaques, which are similar in size but various macerated, is particular specific (“mosaic lesion”). ERYTHEMA is out-lined, deep-red, in the form of “stamped” rounded sports (on the hard palate) or else as erythematous angina (on the molle palate) observed. Erythema were occurred in 13-41% of cases, often with papules were combined. PATHOGNOMIC indications of secondary syphilids are geometry regular form and grouping, rounded and out-lined contours, similarity in size. These peculiarities are attributable to the fact that eruptions are developed in places, where the circulating immune complexes (CIC) were fixated. CIC have bioelectric charge. Therefore, CIC arranged and fixed to a force isolines of natural electrostatic field in the tissue. These isolines have geometry regular form of arc or circle. The mechanism of CIC-fixation can be to describe by biophysical theory DLFO (Deryagin-Landau-Forway-Overbeck). The local conditions for CIC-fixation and for formation of infiltrate (papules) are created by lesions of small arterioles and local blood-stream disorders. Conclusion. Secondary syphilids on the oral mucosa are multiform. The use of photographing is handy for detection of miliary papules, which are often, but barely visible.