Oral Secondary Syphilis: Case Report

OOOO Volume 117, Number 2 CARLA BATISTA DOS SANTOS, MATHEUS HENRIQUE ALVES DE LIMA, THAYNÁ MELO DE LIMA MORAIS, AMANDA LAÍSA DE OLIVEIRA LIMA, SONIA MARIA SOARES FERREIRA. CENTRO UNIVERSITÁRIO CESMAC. Paracoccidioidomycosis is a mucocutaneous disease that often involves the oral mucosa and may clinically resemble other infectious and neoplastic processes. Two Brazilian patients living in Alagoas developed oral manifestations due to Paracoccidioides brasiliensis infection. Woman, 67, and man, 47, both heavy smokers, were seen for diagnosis and treatment. Only the man had previous experience as a farmer. Palpable and symptomatic lymph nodes were observed. Oral examination showed ulcerated lesions with a granular surface located in the gingival, labial, and buccal mucosa. Fungal cells with the characteristic granulomatous inflammatory reaction were present in samples stained with hematoxylin-eosin (HE) and Grocott-Gomori methenamine silver stain. Patients were referred and treated but long-term follow-up is mandatory. The entire diagnosis process was conducted by a stomatologist, although both patients had undiagnosed pulmonary involvement. This case shows that the stomatologist has an important role in early diagnosis and that adequate therapy may prevent extensive tissue destruction.

PE-254 - ORAL POSTINFLAMMATORY PIGMENTATION IN LICHEN PLANUS. FERNANDA PAULA YAMAMOTO SILVA, BRUNNO SANTOS DE FREITAS SILVA, POLYANA FERNANES RODARTE, JULIANO RAPOUZEIRO SEIXAS, ALEXANDRE BELLOTTI, ALINE CARVALHO BATISTA, REJANE FARIA RIBEIRO-ROTTA. FACULDADE DE ODONTOLOGIA DA UNIVERSIDADE FEDERAL DE GOIÁS. Oral postinflammatory pigmentation is characterized by a discoloration of the oral mucosa caused by excess melanin production and deposition within the basal layer cells and connective tissue in areas affected by chronic inflammation. Therefore it is necessary to demonstrate the association with a previous or concomitant inflammatory process in the same area. White woman, 30, presented a bilateral asymptomatic brown pigmentation localized in her buccal mucosa and tongue. However, a small white reticular plaque area was also seen. Microscopic examination showed parakeratosis, bandlike lymphocytic infiltration, incontinent melanin, and melanin-laden macrophages in the connective tissuedall features compatible with oral lichen planus. It is believed that 11% of patients with oral lichen planus have postinflammatory pigmentation of the oral mucosa. Postinflammatory pigmentation should be included in the differential diagnosis of pigmented disease to establish the correct diagnosis and treatment.

PE-255 - ORAL SECONDARY SYPHILIS: CASE REPORT. LARISSA PEREIRA LAGOS DE MELO, TALITA RIBEIRO TENÓRIO DE FRANÇA, MARIA FERNANDA MUNIZ ARAÚJO, JUREMA FREIRE LISBOA DE CASTRO, EDUARDO RODRIGUES FREGNANI, DANYEL ELIAS DA CRUZ PEREZ. UNIVERSIDADE FEDERAL DE PERNAMBUCO. Syphilis is a systemic infectious disease caused by Treponema pallidum. Recently, cases of syphilis seem to be increasing, including the oral manifestation. A case of oral secondary syphilis was reported. Man, 36, was referred for diagnosis of an oral ulcer of 1 month’s duration. Intraoral examination revealed an ulcerated lesion at the tip of the tongue, with borders slightly elevated and firm consistency on palpation. An incisional biopsy was done

ABSTRACTS Abstracts e181 under local anesthesia. Microscopically, a severe chronic inflammatory reaction rich in plasma cells was observed. Based on these, syphilis was the proposed diagnosis, which was confirmed on serological testing. The patient was reevaluated and presented round red patches in the skin, prompting a diagnosis of secondary syphilis. The patient was treated with penicillin, prescribed by an infectologist. Currently, syphilis should be also considered in the differential diagnosis of all single oral ulcers.

PE-256 - ORAL SOFT TISSUE ALTERATIONS IN PATIENTS WITH NEUROFIBROMATOSIS TYPE 1: ANALYSIS OF 37 PATIENTS. RAFAELA ELVIRA ROZZA DE MENEZES, RAQUEL MACHADO ANDRADE, RAQUEL RICHELIEU LIMA DE ANDRADE PONTES, ELOÁ BORGES LUNA, LILIAN MACHADO DE SOUSA ALMEIDA, ELIANE PEDRA DIAS, KARIN SOARES GONÇALVES CUNHA. POSTGRADUATE PROGRAM IN PATHOLOGY, SCHOOL OF MEDICINE, UNIVERSIDADE FEDERAL FLUMINENSE, RJ. Neurofibromatosis type 1 (NF1) is a complex syndrome that may affect all organic systems, including oral mucosa. The oral soft tissue alterations in 37 NF1 patients were reported, including neurofibromas (44.1%) and prominent fungiform papillae (13.5%). The number of neurofibromas varied from 1 to 9 tumors per patient. The most common locations were the lips and alveolar process. Other alterations not associated with NF1 were also observed, such as fissured tongue, benign migratory glossitis, hyperplasia of the lingual frenum, and inflammatory fibrous hyperplasia. Erythematous candidiasis was also observed and confirmed by cytopathological examination in 6 NF1 patients. NF1 is one of the most common genetic diseases and manifests in different forms orally. Therefore clinicians and dentists must be aware of these alterations for proper diagnosis and treatment, as indicated.

PE-257 - ORAL ULCERATIONS BY DISCOID LUPUS ERYTHEMATOSUS: THE IMPORTANCE OF DENTISTS IN MANAGING THESE LESIONS. GRASIELI DE OLIVEIRA RAMOS, THAÍSE GOMES E NÓBREGA, VIVIANE PALMEIRA DA SILVA, PANTELIS VARVAKI RADOS, FERNANDA VISIOLI, MÁRCIA GAIGER DE OLIVEIRA, MARCELO LAZZARON LAMERS. UNIVERSIDADE FEDERAL DO RIO GRANDE DO SUL. Discoid lupus erythematosus (DLE) is a chronic dermatological disease and represents the most common subtype of cutaneouslupus erythematosus. In DLE the lesions remain localized to the skin and/or mucosa. Woman, 49, had oral ulcerations caused by DLE. Oral examination revealed ulcerations with central erythema and irradiating white striations bilaterally in the buccal mucosa. Her skin had numerous disk-shaped lesions characterized clinically by the presence of white plaques and an erythematous halo; these were located on the neck, head, face, back, and hands. The patient uses topical clobetasol propionate 0.05% mg/ml. The dentist may be able to establish the diagnosis of this disease before cutaneous lesions become apparent and can also manage the oral lesions, which occur in about 20% of patients and can be very painful.

PE-258 - OROFACIAL FINDINGS AND DENTAL TREATMENT IN A PATIENT WITH WILLIAMS-BEUREN SYNDROME: CASE REPORT. GRAZIELE BEANES DA SILVA SANTOS, DELANO SOUZA. UNIVERSIDADE FEDERAL DA BAHIA.