Description

Hutchinson described a group of 3 findings in children with congenital syphilis. While some features may be evident at birth, full development of the triad may not occur until late adolescence if the patient remains untreated.


 

Clinical features of Hutchinson's triad:

(1) interstitial keratitis (inflammation of the keratitis) with blindness

(2) sensorineural deafness, usually bilateral, with or without a conduction defect

(3) dental anomalies in permanent teeth, including Hutchinson's teeth

 

Clinical features of the interstitial keratitis:

(1) onset between 5 and 16 years of age, initially unilateral

(2) photophobia

(3) pain

(4) excess tearing

(5) blurred vision

(6) neovascularization with a "salmon patch"

(7) clouding of the cornea (syphilitic nebulae)

(8) eventual blindness

 

Hutchinson's teeth:

(1) small canines and incisors

(2) widely spaced

(3) conical, notched, peg, or screwdriver shaped

(4) hypoplastic and poorly enamelized

 

Other dental anomalies:

(1) Moon's molars (mulberry molars)

(2) cannibal teeth (pointed upper incisors)

(3) tombstone or top hat lower incisors

 


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