Tertiary Syphilis Oral — MFDS Part 1 MCQ
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Correct answer: E — A destructive palatal gumma with possible perforation
A destructive palatal gumma is the characteristic oral manifestation of tertiary syphilis. Gummas are granulomatous, necrotising lesions that can destroy adjacent bone and occasionally produce palatal perforation. A painless indurated chancre is a manifestation of primary syphilis, including when inoculation occurs on the lip. Oral mucous patches and condylomata lata are manifestations of secondary syphilis and are associated with infectious early disease. Koplik spots are small buccal lesions associated with measles, not syphilis. The historical association between tertiary syphilis and interstitial glossitis is recognised, but describing such glossitis simply as a premalignant lesion is insufficiently precise and was removed from the item.
Reference: Guarino P, et al. Description of clinical cases and available diagnostic tools of oropharyngeal syphilis: a systematic review of the literature. BMC Infectious Diseases. 2024;24:1252. https://pubmed.ncbi.nlm.nih.gov/39506662/