Jornal de Pesquisa em Dermatologia Clínica e Experimental
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Tertiary Treponematosis

Herbert B. Allen, Maria Hannaway and Suresh Joshi

With recent findings in arthritis and dementia, it has become apparent that Lyme treponemes and oral treponemes have tertiary clinical findings similar to tertiary syphilis. The primary findings are in the skin or mucous membranes with syphilis demonstrating a chancre, Lyme disease erythema chronicum migrans, and oral treponemes dental plaque. Secondary disease is not as clear in Lyme and oral treponematosis as in syphilis, but tertiary is surprisingly similar with treponemes from all three being found in the brain and joints. Lyme and oral organisms have been visualized in the brain and joints by PCR. "Montauk knee" was actually "Lyme" arthritis before the organism was shown to be the causative agent. With the demonstration of the organisms in these locations, treatment should likely be reconsidered. It would seem most logical to prevent them from arriving there in the first place. This would be entirely similar to the prevention of neurosyphilis by appropriate treatment in the earlier stages. Persistence so these organisms is likely due to biofilm production.