A case of palatal perforation-A rare manifestation of late congenital syphilis

A 49-year old female with palatal perforation due to congenital syphilis is reported. She was diagnosed on the basis of clinical, serological and epidemiological features. Clinical examination showed a ‘Saddle nose’ deformity, and ‘palatal perforation’. Her clinical course was as follows: Her hard palate perforated at the at the age of 10 years. At the age of 16, a fistula closure operation was executed, but soon after the operation perforation of the hard palate recurred. At the age of 37, she lost all teeth of the upper jaw.She has been using a complete denture of the upper jaw since age 41.She recently felt uneasiness with the denture, probably due to thinning of the bone around the premaxilla. She therefore visited our clinic through the introduction of a dental practitioner for examination of the palatal perforation. Her disease history was unnoteworthy. Her laboratory data were all within the normal except for a positive TPHA reaction. Her father was treated for syphilis before her birth. Due to advances in treatment against syphilis, progressively fewer cases of syphilis are encountered. Late congenital syphilis has become particularly rare recently.