Aim

Syphilis is a sexually transmitted disease with growing incidence worldwide. In secondary syphilis, oral lesions are common, sometimes being the only manifestation. Gingival features of syphilis are rare and usually present multiple oral lesions. The aim of this article is to present a series of clinical cases of syphilis with predominantly or exclusively gingival localization, highlighting the most relevant clinical characteristics for its diagnosis.

Clinical cases

This clinical case series included nine cases of secondary syphilis with gingival manifestations. The diagnosis was made using serological tests (VDRL, TPPA, FTA-ABS, and MHA-TP), and both gingival and extragingival lesions were described. Secondary syphilis was observed in the gum, mainly affecting the anterior region —both upper and lower—, depicting red or white plaques. Some cases also presented lesions in other intraoral sites, had symptoms such as pain or burning sensation, or showed plaque induced periodontal disease. The differential diagnosis of secondary syphilis considering non-specific periodontal conditions with gingival involvement is essential for a proper diagnosis. Thus, the diagnosis of secondary syphilis should be considered when dealing with atypical gingivo-periodontal cases in everyday practice.