Secondary syphilis is the stage of the disease that occurs after the primary. It begins 2-5 months after infection and lasts about 2-5 years. Secondary syphilis is characterized by the spread of pale treponema throughout the body. Thus, secondary syphilis affects the entire body and all organs of a person. The symptomatology of this disease is very diverse; therefore, diagnosis is difficult. The manifestation of the disease includes a rash in many of its manifestations, any organ of the human body can be affected, and sometimes only a differential diagnosis can signal secondary syphilis.
Classification of secondary syphilis
Secondary syphilis can manifest itself in several forms. Each of its forms has been described and studied by doctors. Distinguish:
- Secondary fresh syphilis is the international name for Syphilis II recens. This is the next stage in the course of primary syphilis. Secondary fresh syphilis of this stage is characterized by a small rash. Duration is about 2-4 months.
- Secondary recurrent syphilis is the international name for Syphilis II recidiva. At this stage, syphilis in relapse alternates with periods when it is hidden.
- Secondary latent syphilis is the international name for Syphilis II latens. Often for secondary latent syphilis those symptoms that appear in a patient who have begun treatment for primary syphilis, but have not completed the full course, are taken.
Secondary syphilis symptoms
Rashes at the secondary stage of syphilis are characteristic:
- Lack of soreness and itching;
- Density of elements;
- In red, sometimes in a purple or dark shade;
- Round outlines and fragmentation of elements;
- Lack of peeling;
- Spontaneous disappearance without scarring;
Secondary syphilis, in addition, is characterized by the following various manifestations:
- Roseolous syphilide Most often, syphilis manifests itself in this way. Roseolous syphilis means that the pale spirochete has begun to spread throughout the body. Roseola is a blemish that is inflammatory, but not acute. Such roseola is usually pink or pale pink in color, has an indistinct outline, round or oval shape. Roseola is usually 1-1.5 cm in diameter and does not rise above the skin. In addition, such spots exist scattered and do not tend to grow. Roseola most often appears and spreads on the human body, especially the stomach. It occurs due to disruption of the blood vessels.
- Papular syphilis Syphilis is also often manifested at the stage of relapse in the form of papular syphilis. The symptom is a papule or nodule, characterized by a round shape, dense but elastic consistency. The size of a papule can be the size of a pea. It features a smooth surface at first, which becomes rough and flakes over time. This peeling usually forms a border around the edge - Biette's collar. The papule can appear anywhere, but most often it can be found on the genitals or on the palms and soles. Papular syphilis can come and go, this is called a "wave". An analysis of the nature of such rashes is called the Wasserman reaction - this is a blood sample, the diagnosis of which confirms or excludes syphilis.
- Palmar-plantar syphilis It is a type of papular syphilis. May present with symptoms such as callus-like nodules. Such a papule will stand out sharply on the skin, have a smooth surface and a bright red, purple or brown color. The papule is initially intact, but in the process of development it can crack and flake off, which makes its similarity to a corn especially pronounced. That is why the papule often goes unnoticed, the patient does not even know that he has this form of the disease for a long period.
- Wide and anal warts Very often, syphilis manifests itself in the following symptoms: a vegetative papule, prone to unification with others, is localized throughout the body, and most often in the anus (anal warts). Such a papule can be hypertrophied, characterized by a white bloom and a swollen stratum corneum. Often, wide warts are the only manifestation that secondary syphilis gives out.
- Syphilitic leukoderma The "necklace of Venus" used to be such a common symptom of syphilis that it got its own name. Today, leukoderma may appear less frequently, and is also known as pigmented syphilis. This symptom is characterized by a manifestation in the period 4-6 months after infection; syphilis, thus, is expressed in the appearance of discolored age spots on the neck. These syphilis are not painful and can remain on the skin for months or years.
- Erythematous sore throat Roseola on the mucous membrane of the mouth is a symptom of the so-called syphilitic sore throat. Secondary syphilis, thus, manifests itself in the red color of the pharynx, clear outlines of roseola. These syphilis may be the only symptom of recurrent secondary syphilis. In some cases, there is a symptom such as hoarseness. It can manifest itself in the defeat of the vocal cords and a change in the timbre of the voice.
- Syphilitic baldness Hair loss, which occurs in a fifth of patients, can be diffuse and occur over a large area of the scalp, or have a small focus. Small focal baldness is a clear sign of syphilis, the diagnosis of which is easy. Diffuse baldness is a more difficult symptom to analyze, since its nature is not eloquent and can be inherent in many diseases. Diagnosis of diffuse baldness should be carried out by a specialist, and treatment for this symptom of syphilis will resume hair regeneration.
Diagnosis of secondary syphilis
The basis for confirming the diagnosis is the general clinical picture, which includes laboratory tests. Typically, confirmation can be sought using several different methods:
- Research in a dark field - carried out using a microscope. Allows you to observe microorganisms in a living state.
- Microreactions of precipitation - an analysis that determines the presence of antibodies produced by the body to resist the spread of treponema pallidum.
- Immunofluorescence reactions - the study combines a complex of antigens and antibodies with an anti-species serum. It is most commonly used to rule out false positive syphilis test results.
- The passive hemagglutination reaction is widely used to determine all possible stages of the disease. Secondary syphilis can be easily detected with this treponemal test.
- The Wasserman reaction is gradually being replaced by other methods. Diagnostics using this analysis is less common.
- Enzyme-linked immunosorbent assay - has several dozen modifications. It is used to show any genital infections, and secondary syphilis is also diagnosed.
Differential diagnosis
Secondary syphilis is investigated with a differential method in the presence of external signs and symptoms. For example, differential diagnosis will be carried out if there are diseases such as lichen rosacea, "Venus necklace", bite spots, rubella, measles, lichen, spotted taxidermy. Thus, those diseases are covered, the manifestations of which include rash, various problems of a dermatological nature, multiple lesions of the skin and mucous membranes, condylomas.
Treatment of secondary syphilis
To begin with, it should be noted that the treatment of secondary syphilis should be comprehensive and the patient should be constantly monitored by a doctor. Therapy usually consists of a course of antibacterial drugs for a specific period. Usually, the period for taking medications is quite long, at least it can be 24 days. Treatment usually includes antibiotics of the penicillin group, since the causative agent of syphilis is susceptible to this particular range of drugs. In general, secondary syphilis lends itself well to healing, the main thing in this enterprise is to strictly follow the instructions and constantly be monitored by the doctor.
Therapy consists of regular intramuscular injections every three hours. Such treatment is best done in a hospital, but in special cases it can also be done at home.
In addition, treatment may include taking immunostimulants, biogenic stimulants, or ultraviolet radiation. Separately, the doctor sometimes prescribes vitamins for the period of treatment.
Recently popular therapy "one injection", especially promoted in government agencies. It is worth noting that secondary syphilis cannot be cured in this way, since only an integrated approach can defeat this disease. However, the desire to quickly and easily cure syphilis in this way can lead to the opposite result: the appearance in the patient's body of bacteria super-resistant to antibiotics.
Secondary syphilis is especially dangerous for women because it can be passed on to an unborn child. Statistics show that the birth of a healthy child in the event that secondary syphilis has not been treated or passed into the latent stage is almost impossible. Also, pregnancy itself is unlikely: secondary syphilis will interfere with the delivery of the child. However, if a woman completely cures secondary syphilis and undergoes the necessary therapy, is observed by a doctor, then she will have a normal baby, born healthy and without pathologies.
Therefore, secondary syphilis (like any other disease) must be diagnosed and treated by a professional using a wide range of medications. The use of antibiotics in combination with immunomodulators can lead to positive results, complete cure and recovery from symptoms. The doctor will help his patient to overcome secondary syphilis, but you need to approach this issue in a very disciplined way - only then success will await on this path.
24.06.2017
Syphilis is an infectious disease caused by a microscopic mobile spirochete called Treponema pallidum.
A spirochete is not a bacterium, but it is not an organization of protozoa either. This is something in between. Syphilis is transmitted from a person who has syphilis in the first or second stage of development.
Infection has three routes of infection:
- Sexual. When partners have intercourse, while not using protection, you can easily become infected with treponema pallidum.
- Contact and household. You can get infected by using shared underwear, wet towels, bath accessories, if an infected person has used them before.
- Vertical. Pale treponema is transmitted by a sick mother to a child. This bacterium easily crosses the placental barrier and is excreted during breastfeeding. Therefore, the baby can become infected in utero and during breastfeeding.
Alkaline soaps, disinfectants, drying and heating negatively affect the development of pathogenic microorganisms. For a long time, treponema lives in moist vaginal discharge, blood plasma.
Syphilis has a strict staging course. It develops in four stages:
- Incubation - the infection begins to develop in the body two weeks after infection, and then you can notice signs of secondary syphilis. The maximum stay in the body is six months.
- At the primary stage, treponema forms a hard chancre. Within five days, local reactions of the nodes of the lymphatic system join the chancre. After a month, these changes can go away on their own without appropriate treatment.
- The secondary stage of syphilis begins to manifest itself two or three months after infection. A rash appears on the body and limbs of the infected person. This is due to the fact that hematogenous dissemination of pathogenic microorganisms begins in various parts of the human body. An inflammatory reaction along the skin capillaries also begins. The course of this stage in the development of syphilis is influenced by the patient's immune reactivity. As a rule, a rash on the body does not give the patient any unpleasant sensations. After a few weeks, the rash goes away on its own, but after two or three years it may reappear.
- The tertiary stage of development begins with specific inflammations, they are also called syphilitic gums. When they start to disintegrate, the destruction of healthy tissue begins. After that, large defects are formed, in the form of a sinking of the nose and destruction of the palate. this stage of development of an infectious disease can severely affect the cerebral cortex and ends with damage to the spinal cord, impaired muscle strength and immobility of the upper and lower extremities.
When the disease progresses to the last stage, it is quite difficult to help the patient.Often, syphilis results in severe disability, or complete dysfunction of vital organs.
It is easier for doctors to diagnose the disease when the symptoms of the secondary stage begin.
What is secondary syphilis
The secondary period of syphilis begins after the primary period, as a result of not timely treatment. Its first manifestation begins two, three months after pale treponema enters the body. There are frequent cases when the second stage of syphilis passes in a latent form and does not give out even the slightest symptoms. Pale treponema can live in the body from two to five years. After this, the tertiary stage begins, which can also proceed in a latent form.
The secondary period differs from others in that it is easy to transfer it to someone, that is, to infect. In almost all cases, the period has a pronounced clinical picture, which allows the patient to consult a doctor and diagnose an infectious disease. even if an infected person does not have intimacy, he is still capable of infecting another person. This happens in everyday life, for example through dishes, towels, a toothbrush and other personal or hygiene items. Therefore, the treatment of secondary syphilis should be carried out in a hospital.
When the patient has the first skin rash, it means that secondary fresh syphilis has begun. This is due to the penetration of treponema pale into the circulatory and lymphatic system.
Thus, it spreads throughout the body. A rash on the body may not go away for up to three months, and after that it begins to fade and disappear. This is how immunity resistance is manifested. After a while, the rashes appear again.
A repeated outbreak of infection indicates secondary recurrent syphilis. Such processes can be observed for up to two years.
Symptoms of the secondary period of syphilis
At the initial stage of development, secondary syphilis has general symptoms that are similar to the manifestation of an acute respiratory viral infection or influenza. The patient experiences rapid fatigue, headache and chills. Often, when the body temperature rises. Unlike other stages, the secondary can be accompanied by unreasonable joint and muscle pains, often worsening during a night's sleep. After all these symptoms appear, rashes on the skin may begin.
The rash that occurs during this period is called secondary syphilis. Such rashes have their own characteristics:
- the rash is benign, with no peripheral growth;
- do not destroy the surrounding tissue;
- have a rounded shape with clear boundaries;
- there is no subjective symptomatology. In rare cases, the rash may itch;
- there are no acute inflammatory signs;
- heal without scarring.
Secondary syphilis consists of a large concentration of pathogenic microorganisms. This factor indicates the danger of secondary syphilis.
The most common forms of skin rashes are syphilitic roseola and spotted syphilis. They are pale pink in color and have a rounded shape with a diameter of no more than ten millimeters. As a rule, the localization of spots is on the skin of the body, upper and lower extremities. In rare cases, they can be seen on the skin of the face, feet and hands. Syphilitic roseola during the secondary stage of development of an infectious disease appear in 11-13 pieces per day. This takes one week. To distinguish roseola from other forms of rash, you just need to press it. When pressed, the roseola disappears.
Much less often, in a patient, you can notice a rash in the form of flaky (lamellar scales with a sinking center) and volumetric (rises a few ml above the skin) roseola.
Another type of manifestation of the secondary period of syphilis is papular syphilis. They look like tightly elastic papules with a diameter of no more than 6 mm. They are pink or coppery red. After a certain period of time, the center of the densely elastic papule begins to peel off and spreads to the peripheral zones. Also, the papule can peel off only along the edge, but after the center is peeled off. When papules begin to rapidly disperse along the skin, long-term hyperpigmentation begins. They can be seborrheic, coin-shaped, psoriasiform, weeping syphilis and papular forms.
The most rare form of rash appears as pustular syphilis. It manifests itself in patients with weak immunity or with other serious pathologies, such as drug addicts, alcoholics or patients with tuberculosis. This is a sign of a severe course of the secondary period of syphilis. Such rashes have a purulent exudate, which, when dried, forms a yellowish crust. Clinically, the rash is confused with pyoderma. Syphilis of a pustular type, it is impetiginous, acne-like, ectymatous, smallpox, and rupoid.
Recurrent secondary syphilis is characterized by pigmented syphilis (syphilitic leukoderma). They appear on the side and back of the neck and are round in shape. The color of the rash is whitish.
Rashes on the skin cause a generalized enlargement of the nodes of the lymphatic system. The enlargement of the cervical, axillary, femoral, inguinal lymph nodes is painless and does not fuse with the tissues that surround them.
Secondary syphilis can provoke hair loss, which often ends with diffuse or alopecia areata. The patient notices that the mucous membrane of the mouth and larynx has become inflamed. If the mucous membrane of the larynx is affected, the patient may become hoarse.
Somatic organs suffer from functional changes. If you start treatment in a timely manner, you can quickly get rid of these symptoms. The liver is affected and the liver function is impaired. The patient often experiences pain during this. On an ultrasound, the doctor fixes its increase in size. Often when patients with secondary syphilis are diagnosed with gastritis and dyskinesia of the gastrointestinal tract. Lipoid nephrosis and high blood protein levels may also occur.
The patient becomes irritable due to sleep disturbance and insomnia.
In rare cases, symptoms of secondary syphilis are accompanied by syphilitic meningitis, but it is easily treatable. The skeletal system is affected, and osteoperiostitis and periostitis develop, which are accompanied by acute pain of the lower extremities at night.
Diagnostics of the secondary period of syphilis
A doctor cannot diagnose only if a patient has skin rashes, accompanying signs, or infections as indicated by a medical history.
First of all, doctors take a scraping from a loose element on the skin for further study in laboratory conditions under a microscope.
These tests can detect the presence of pale treponemas. During the entire diagnosis, doctors monitor the results of the Wasserman reaction. Her indicators are positive during the period of fresh secondary and recurrent syphilis. After the patient is finally diagnosed with secondary syphilis, treatment begins immediately.
Treatment
During treatment, patients are strictly prohibited from having intimacy. You also need to be careful at home. The patient should use only his household utensils, personal hygiene products and make sure that no one from his relatives uses them.
When a patient is undergoing treatment at home, he should only eat from his dishes, dry himself with his towel, use his washcloth and soap. If the patient has a regular sexual partner, then during the treatment period it is necessary to sleep on different beds and avoid close contact. Since all rashes on the skin have a high concentration of pale treponemas.
Due to the fact that almost all patients cannot cope with these rules, patients diagnosed with secondary syphilis are treated in an inpatient setting.
In the treatment of secondary syphilis, antibiotics are used, which are given intravenously. An antibiotic injection is given every four hours, which is also much more convenient in a hospital. This allows for greater effect.
The most effective antibiotics today are penicillins. Water-soluble penicillin is injected every three hours, and injections with benzylpenicillin salt are given in the sutra and in the evening.
Outpatient therapy is carried out with prolonged-release drugs Bitsillin. The drug is administered once every 48 hours. If the patient has an allergic reaction to penicillin, then treatment is carried out with Doxycycline, Tetracycline, Erythromycin or Azithromycin.
In addition to injections with antibacterial drugs, doctors use immunostimulants, for example, Pyrogenal, Methyluracil and others.
For internal use, doctors prescribe multivitamins.
Local therapy is aimed at treating the elements of skin rashes, using chlorhexidine and lubricating with heparin ointment. The ointment helps to speed up the absorption process.
If there is a patient in the family with a diagnosis of secondary syphilis, then all family members take the appropriate tests. Even if they have no signs and skin rashes. And the sexual partner of the infected person undergoes preventive treatment, the duration of which is several weeks.
Secondary syphilis begins some time after the primary illness. Pale treponema affects 80% of the skin, spreads to the mucous membranes and affects the work of internal organs. The infectious process seriously affects the patient's quality of life.
What is secondary syphilis
To make it easier to understand what secondary syphilis is, let's analyze the stages of the pathology. The violation proceeds in 4 stages:
- Incubation. After infection, it may take 2-3 weeks before the patient notices the discomfort and symptoms of syphilis.
- Primary. Treponema contributes to the formation of a hard chancre. In the next week, reactions of the nodes of the lymphatic system will join him.
- Secondary. Begins several months after infection. Extensive rashes appear on the body due to the spread of treponema throughout the body. The capillaries begin to undergo an inflammatory reaction.
- Tertiary. Severe inflammation or syphilitic gum occurs in the body. The destruction of healthy tissue occurs and the formation of serious defects such as destruction of the palate or sinking of the nose.
It is best to start treating syphilis at a latent stage, but at this stage only a doctor can detect it.
Tertiary inflammation results in severe disability or failure of vital organs.
Secondary syphilis occurs due to delayed initiation of treatment. A few months after the appearance of pale treponema in the body, symptoms of the disease appear. In rare cases, the secondary stage is asymptomatic. In the body, the infection can live up to 5 years.
Relapse is dangerous because it is easily transmitted from one person to another. Even in the absence of sexual contact, there is a risk of infection of loved ones. The transmission of treponemes through personal hygiene products is possible. For example, through linen, toothbrush, washcloth and other things. Symptoms of secondary syphilis will be acute, so the patient should see a doctor as soon as possible for help if discomfort is found. Medical care is provided in a hospital setting.
The secondary form is characterized by profuse skin rashes. At this time, treponemas affect the circulatory and lymphatic systems, spreading throughout the body.
Signs and symptoms of secondary syphilis
An exacerbation of the disease is easy to detect as a rash spreads all over the body. However, one should not dismiss skin lesions, since the same changes occur with the internal organs of a person. First of all, the gastrointestinal tract suffers, then the functioning of the respiratory, reproductive system and visceral organs is disrupted.
The main symptoms of secondary syphilis are:
- rash on mucous membranes and skin;
- discoloration of the skin;
- syphilides (inflammatory elements) on the mucous membranes and skin;
- loss of hair.
The asymptomatic form of sexually transmitted disease occurs in patients who use strong antibiotics to treat any disorder. The medications prescribed earlier by the doctor are not able to completely eliminate treponema, therefore the infection proceeds in a latent form.
Rash
Each spot (roseola) has a diameter of 2 to 15 mm, the rashes do not merge with each other and have a clear edge. Pain is felt on palpation, but there should be no itching or fever. The surface of the spot does not form a build-up, so it practically does not protrude above the skin. When pressed on roseola, it turns pale and becomes normal skin color. Even during the period of therapy, the skin does not peel off, this is a distinctive feature of a rash with syphilis.
Roseola appear rather slowly, the period of their spread is 2-3 days. In secondary syphilis, the spots are asymmetrical and large in size. The rash can cluster in rings or other patterns. Roseola sticks to the body from several weeks to 3 months.
Then they disappear even without medication, but this does not mean that the disease has passed. After a while, a relapse will reappear, which will aggravate the patient's condition.
Papular syphilis
Papular syphilis is a papule that appears due to the accumulation of cellular infiltrate and is located in the upper dermis. Inflammations protrude above the surface of the skin, have a round or oval shape. They have a dense consistency and stay on the body for several months. Papules are located on the trunk, face, palms, mucous membranes, scalp and genitals.
Syphilis re-flows through:
- Miliary papular syphilis. The patient develops small blisters near the sebaceous glands. They are covered with scales, have a pale color and a dense texture. In syphilis, they are located mainly on the back, abdomen and chest. Miliary papular syphilis occurs in immunocompromised people. This group includes people with chronic diseases and those who abuse alcohol. This type of rash is resistant to medications, so it stays on the skin for a long time.
- Lenticular papular syphilis. The rashes take the form of a shortened cone and a smooth surface. Their color can be pink, yellow or blue. When pressed, a sharp pain is felt. Papules are located on the head or neck, outwardly resemble psoriasis.
- Numular papular syphilis. The appearance of flat, large rashes about 2 cm in size indicates numular syphilis. They will have a brown or blue tint, and can be combined with other types of rashes. After treatment at the site of the papules, there is a possibility of pigments or scarring, and skin atrophy may also occur.
Pupular syphilides are contagious because they contain a lot of pathogenic trace elements.
In this case, even shaking hands, kissing or hugging can cause syphilis.
Pustular syphilis
Doctors note that in their practice, patients with pastular syphilide were extremely rare. A rash is diagnosed in people with abnormally low immunity or malignant tumors. Treponemas depress the general condition of the body, so the patient suffers from headache, weakness and fever.
Pustular syphilis has its own classification, it can be acne-like, impetigo, smallpox, and also have the form of syphilistic ecthyma or rupee.
Acne-like syphilis is located on the head, neck and upper body. Scanty rashes do not affect the general condition of the patient. The pustules are small and form a crust over time, which falls off by itself. Ospenoid syphilis occurs in debilitated patients. The pustules do not exceed a pea in size, they can easily be confused with the smallpox element.
Impetiginous syphilide has a brown tint, the rash can suppurate, and then shrink into a crust. The pustules are large and can merge with each other. Syphilis is located on the hairy areas of the body and heals for a long time. At the site of the formation of pustules, pigment spots will remain, over time they will pass.
Sphilistic ecthyma is one of the most severe forms of the disease. It is observed in patients 5-6 months after infection. Large pustules reach a diameter of 3 centimeters or more. They crust over and have a large compaction. The rashes rise above the skin, have a blue tint. This symptom of syphilis occurs in pregnant women and men with immunodeficiency. The photo on the right shows what an ecthyma looks like.
The rupee reaches 5 cm in diameter. Blood or pus will periodically come out of a deep ulcer. During the progression of syphilis, it occurs on the legs and is combined with the rest of the syphilis.
Alopecia
During syphilis, the rash can be combined with partial baldness. Hair begins to fall out due to the influence of treponema on the bulbs. Pathogenic microorganisms provoke inflammation of the follicle, in this regard, the nutrition of the hair stops and it falls out.
Diffuse baldness with syphilis is rare. During this, the hair falls out evenly starting from the temples. In addition, the hair becomes dry and looks like a wig.
Hair growth will resume within a few months after starting treatment.
Diagnostics of the secondary period of syphilis
Prescribing medications is possible only after drawing up a complete clinical picture and conducting laboratory tests. Despite the fact that characteristic symptoms appear during syphilis, the doctor must make sure that a sexually transmitted disease is present and confirm the diagnosis.
For this purpose, a scraping is taken from the affected cavity. Biological material is examined under a microscope for the presence of treponemas. An immunological study is also carried out, which allows you to determine the exact shape of the rash.
Features of the treatment of secondary syphilis
Patients with a confirmed diagnosis are prohibited from having sex during treatment. Also, people with syphilis are advised to be more careful in order to prevent infection of the people around them. The person should use a personal towel, cutlery, dishes and soap. If you have a sexual partner, it is recommended to sleep in different beds and refuse bodily contact.
Few can follow such rules, therefore, so that the transferred illness does not affect other family members, patients are admitted to a hospital.
Secondary syphilis is treated with antibacterial agents. For a quick effect and maximum relief of the state of health, drugs are administered intravenously. The most effective penicillin drugs against treponema. Injections with this component are done every 3 hours.
For home treatment, binicillin is prescribed. It is consumed once every 2 days. For allergies or side effects, prescribe azithromycin, tetracycline, or doxycycline. Treatment of secondary syphilis should be comprehensive, since strong antibiotics can negatively affect the condition of some internal organs. Therefore, in addition to them, immunostimulants, multivitamins and probiotics are prescribed.
To improve the immune system, doctors may recommend methyluracil or pyrogenal. Almost any multivitamin complex is suitable.
Abundant skin rashes appearing during syphilis must be treated periodically.
For this, heparin ointment or chlorhexidine is used. Local preparations accelerate the absorption and healing process.
Prevention methods
The advanced form of syphilis can lead to serious health problems. Therefore, everyone should study in advance the preventive measures that help prevent the disease:
- the use of barrier contraceptives during intercourse, they are needed regardless of whether vaginal, oral or anal sex is practiced;
- the use of prophylactic drugs that improve the functioning of the immune system;
- regular passage of a full medical examination and delivery of the necessary tests;
- use of personal hygiene products;
- refusal to visit a public bath, sauna or pool during a period of illness.
There is also urgent prevention of syphilis, it is used immediately after unprotected intercourse. In this case, it is necessary to urinate and rinse the genitals with a disinfectant. Immediately after that, visit a dermatovenerologic dispensary. Most of them work around the clock, so the examination is carried out at any time.
Syphilis can seriously affect your health, so if you suspect, seek medical attention.
The secondary period of syphilis often begins with prodromal phenomena, which usually occur 7-10 days before the appearance of secondary syphilides. More often they are observed in women or debilitated patients and in time coincide with the massive spread of pale treponema in the patient's body by hematogenous route. Weakness, decreased performance, weakness, headache, pain in muscles, bones, joints (aggravated at night, which is characteristic of syphilis), fever (up to medium numbers, less often up to 39-40 ° C) are noted. Often this condition is regarded by patients and doctors as influenza, which delays the timely diagnosis of syphilis. During this period, leukocytosis and anemia can be observed in the blood. As a rule, with the appearance of clinical symptoms of the secondary period of syphilis, the prodromal phenomena, which are far from all patients, disappear.
Secondary syphilis is characterized by a variety of morphological elements that are located on the skin and visible mucous membranes, as well as (to a lesser extent) changes in internal organs, nervous system, locomotor apparatus, etc. Secondary syphilis develops in 2-2.5, less often 3 months. after infection. Without treatment, relapses can recur several times over several years or more. In the intervals between rashes, a diagnosis of secondary latent syphilis is established.
Syphilis in secondary syphilis have common symptoms:
all elements are benign, they usually do not destroy tissues, do not leave scars, except for rare cases of malignant syphilis, accompanied by ulceration, spontaneously disappear after 2-3 months, usually not accompanied by a violation of the general condition;
rashes are not accompanied, as a rule, by subjective sensations. Only in the presence of a rash on the scalp and in large folds of the skin, some patients complain of slight itching;
in the elements there are no signs of acute inflammation, they have a copper-red, stagnant or brownish tint, and then their color becomes faded, "boring", the latter reflects not only the tone of color, but also the very course of the rash of secondary syphilis;
the rashes have a rounded shape, they are sharply delimited from healthy skin, are not prone to peripheral growth and fusion, in this regard, they are located focal, remaining delimited from each other;
expulsion is characterized by polymorphism, since secondary syphilis is often characterized by the simultaneous rash of various syphilis, which causes true polymorphism, and the paroxysmal appearance of syphilides causes evolutionary or false polymorphism;
syphilides quickly dissolve under the influence of anti-syphilitic treatment;
serological blood tests (RSK, RW) and sediment tests are sharply positive in almost 100% of cases with secondary fresh syphilis (with a high titer of reagins - 1: 160, 1: 320) and in 96-98% of patients with secondary recurrent syphilis (with a lower titer of reagins). In almost 100% of cases, a sharply positive result is noted when examining the blood of patients with the help of RIF. The reaction of immobilization of pale treponemas (RIBT) gives a positive result in almost half of patients with secondary fresh syphilis (60-80% immobilization) and in 80-100% of patients with secondary recurrent syphilis (90-100% of immobilization). Up to 50% of cases of secondary recurrent syphilis are accompanied by pathological changes in the cerebrospinal fluid in the absence of a clinical picture of meningitis (the so-called latent, latent syphilitic meningitis).
Syphilides consist of vascular spots (roseola), nodules (papules) and, much less often, vesicles (vesicles), pustules (pustules). In addition, secondary syphilis includes pigmented syphilis (syphilitic leukoderma) and syphilitic hair loss (alopecia).
With secondary fresh syphilis, syphilis are smaller, more abundant, of a brighter color, are located symmetrically, mainly on the skin of the trunk, do not tend to cluster and merge, as a rule, do not peel off. In most patients, you can find the remains of a hard chancre and pronounced regional lymphadenitis (in 22-30% of patients). In addition, polysleradenitis is better expressed (enlarged, densely elastic consistency, mobile, painless lymph nodes in the armpit, submandibular, cervical, cubital, etc.). Polyadenitis occurs in 88-90% of patients with secondary fresh syphilis.
With secondary recurrent syphilis, the elements of the rash are larger, less abundant, often asymmetrical, prone to grouping (the formation of figures, garlands, arcs), paler in color, with frequent localization in the perineum, inguinal folds, on the mucous membranes of the genitals, mouth, etc. e. in places subject to irritation. If with secondary fresh syphilis in 55-60% of patients, a monomorphic roseolous rash is observed, then with secondary recurrent syphilis it occurs less often (in about 25% of patients), more often there is a monomorphic papular rash (up to 22% of cases).
Spotted syphilis (syphilitic roseola) - the most common form of skin lesions in secondary fresh syphilis.
Roseola is first pink, and then pale pink, with indistinct outlines, rounded, up to 1 cm in diameter, non-merging spots with a smooth surface, which do not have peripheral growth and do not rise above the surrounding skin. Roseola appears gradually, 10-12 elements per day and reaches full development in 7-10 days, which explains the different intensity of its color. When pressed on roseola, it temporarily disappears or turns pale, but after the pressure stops, it reappears. Only when you press on the long-existing roseola, a yellowish color remains in place of the pink, due to the breakdown of erythrocytes and the deposition of hemosiderin. Long-term roseola becomes yellowish-brown in color. Roseola is located mainly on the trunk and limbs. The skin of the face, hands and feet is rarely affected. Roseola is not accompanied by subjective sensations. Having lasted an average of 3-4 weeks without treatment, roseola gradually disappears.
With secondary fresh syphilis, roseola is located randomly, but symmetrically and focal. Roseola with secondary recurrent syphilis occurs in smaller quantities than with secondary fresh syphilis, is usually localized only in certain areas of the skin, often grouped to form figures in the form of arcs, rings, half arcs, while leaving the focus of its location. At the same time, the size of recurrent roseola is slightly larger than the size of fresh roseola, and their color has a cyanotic hue. In patients with secondary fresh syphilis, after the first injections of penicillin, an exacerbation reaction usually occurs (Herxheimer-Yarish-Lukashevich reaction), accompanied by an increase in body temperature and increased inflammation in the area of syphilitic rashes. In this regard, roseola, acquiring a more intense pink-red color, is clearly visible. In addition, during an exacerbation reaction, roseola may appear in places where it was not before the start of treatment.
In addition to the typical roseola, the following varieties are distinguished, which are extremely rare:
flaky roseola - lamellar scales appear on the surface of the spotted elements, resembling crumpled tissue paper, and the center of the element seems to be somewhat sunken;
elevated roseola (elevated roseola) - in the presence of perivascular edema, it rises slightly above the level of normal surrounding skin, resembling a blister, but is not accompanied by itching.
Differential diagnosis. Diagnosis of syphilitic roseola, especially with fresh secondary syphilis, is usually not difficult. When carrying out the differential diagnosis of spotted syphilis, one should bear in mind the spotty rashes that occur with some acute infections (rubella, measles, typhoid and typhus), toxidermia, lichen rosacea, pityriasis versicolor, spots from bites from plovers. However, rashes in acute infections are always accompanied by a rather high body temperature and general phenomena. In patients with measles, a profuse, large, merging, bright rash first appears on the face, neck, trunk, extremities, including the back of the hands and feet; with regression of the rash, the rash peels off. On the mucous membrane of the cheeks, sometimes on the lips, gums, there are point whitish spots of Filatov-Koplik. In patients with rubella, the rash first appears on the face, then on the neck and spreads to the trunk. Rashes of a pale pink color, the size of a lentil, have a round or oval shape, without a tendency to merge, often stand somewhat above the level of the skin, exist for 2-3 days and disappear without a trace; at the same time, similar rashes occur on the mucous membrane of the pharynx; itching sometimes worries.
Rashes with typhoid and typhus are always accompanied by severe general phenomena, roseola with typhoid is not so abundant, often takes on a petechial character; in addition, in these cases, there is no primary sclerosis, scleradenitis, polyadenitis.
In cases where the appearance of syphilitic roseola is preceded by prodromal manifestations with fever, the latter is not as high as with typhoid fever, and disappears in the very first days after the appearance of roseolous rashes.
Spotty rashes with toxidermia, which occur when taking medications or poor-quality food, are distinguished by an acute onset and course, bright color, rapid attachment of peeling, a tendency to peripheral growth and fusion, they are often accompanied by burning and itching.
In patients with pink lichen Gibert, in contrast to syphilitic roseola, at first more often in the area of the lateral surface of the body, a so-called maternal plaque appears, which is an oval, pink-red spot about 1.5x3 cm in size or more with a thin lamellar yellowish scale, wrinkled, like a wrinkled cigarette paper. After 1-2 weeks. a large number of similar elements appears, but of lesser size, which are located along the metameres with their long diameter.
With pityriasis (multi-colored) lichen, in contrast to syphilitic roseola, non-inflammatory, coffee-with-milk-colored, flaky spots prone to fusion appear, more often in the upper body. When such spots are smeared with iodine tincture, they turn darker than the surrounding skin.
Spots from ploshchit bites differ from syphilitic roseola in a grayish-purple color, the presence in the center of some spots of a barely noticeable hemorrhagic point from a bite of pubic lice; these spots do not disappear with pressure.
When conducting a differential diagnosis of syphilitic roseola with the above diseases, the absence of other clinical symptoms of secondary syphilis, as well as the results of a serological examination of patients, are of great diagnostic value.
Papular syphilis - the same frequent manifestation of secondary syphilis, as well as roseola. But if roseola is the most frequent manifestation of secondary fresh syphilis, then papular syphilis is a secondary recurrent syphilis. By size, large-papular, or lenticular, and small-papular, or miliary, syphilides are distinguished.
Lenticular papular syphilis is the most common type of syphilitic papules, which have a dense elastic consistency, rounded, sharply limited outlines, hemispherical, size from lentils to peas (0.3-0.5 cm in diameter). They are not prone to peripheral growth and fusion. The color of the papules is pink at first, later becomes copper-red or bluish-red (ham). The surface of the papules in the first days is smooth, shiny, then begins to peel off. Peeling of papules begins in the center and ends earlier than on the periphery, which causes the appearance of marginal peeling of papules in the form of Biett's "collar". Pressure on the center of the nodule with a blunt probe causes severe pain (Jadasson's symptom). Papular syphilides do not appear on the skin immediately, they appear jerky, reaching full development after 10-14 days, after which they hold firm for 6-8 weeks, therefore, in the same patient, you can see papules in different stages of development. After the resolution of the papules, pigmentation exists in their place for a long time.
With secondary fresh syphilis, papules are symmetrically, randomly scattered on the skin of the trunk and extremities, often on the face, scalp. In patients with secondary recurrent syphilis, papules are few in number, tend to be grouped in the form of rings, garlands, arcs, half-arcs and localization in their favorite places (genitals, anal region, oral mucosa, palms, soles, etc.).
There are the following clinical varieties of secondary papular syphilides: psoriasiform, coin-shaped, seborrheic, palms and soles, weeping, wide condylomas, etc.
Seborrheic papular syphilide localized on areas of the skin rich in sebaceous glands, mainly in persons suffering from oily seborrhea on the face, especially in the forehead on the border with the scalp (crown of Venus), in the nasolabial, nasal and chin folds, on the scalp.
Papules are covered with yellowish or grayish-yellow fatty scales.
Psoriasiform papular syphilide characterized by the presence on the surface of the papules of a large number of silvery-white lamellar scales, due to which these elements become similar to psoriatic eruptions.
Coin-shaped (nummular) papular syphilis It is represented by rounded papules with a diameter of 2 rubles or more with a somewhat flattened hemispheric surface, brownish or red in color. It occurs mainly with recurrent syphilis. In this case, single rashes are noted, which are usually grouped.
Papular syphilis of the palms and soles differs in its peculiar appearance. At first, papules almost do not rise above the level of the surrounding skin and have the appearance of sharply limited reddish-purple or yellowish spots with dense infiltration at the base. Subsequently, dense, difficult to remove scales are formed on the surface of such elements. The peripheral part of the element remains free of scales.
After a while, the stratum corneum in the central part of the papule cracks and the papule begins to peel off, gradually forming Biett's "collar".
Such papules in the area of the palms and soles can occur with fresh, but much more often with recurrent secondary syphilis. Moreover, the older the syphilis, the more pronounced the asymmetry of the location of the rashes, including on the palms and soles, their grouping into rings, arcs and merging into large plaques with scalloped outlines, sometimes pronounced peeling, cracks, which is characteristic of late recurrent syphilis.
Sometimes keratinization of the surface of papules on the palms and soles reaches a significant degree, and callus-like thickenings are formed. However, they are always surrounded by a sharply limited stagnant red dull rim.
Weeping papular syphilis is formed when lenticular papules are localized in places with increased sweating and are constantly exposed to friction (genitals, anal region, inguinal-femoral, intergluteal, axillary folds, interdigital folds of the feet, under the mammary glands in women, etc.). In this case, maceration and rejection of the stratum corneum from the surface of the papule occur, as a result of which a properly rounded oozing erosion occurs. In the serous discharge of erosive papules, there is a large number of pale treponemas. Under the influence of prolonged irritation by friction, weeping papules can increase in size and merge into plaques with large scalloped edges. Under the influence of prolonged irritation and the addition of a secondary infection, the erosive papule can ulcerate. The sharp detachment of each element from the surrounding healthy skin, the elevation of erosion above the surrounding surface and mild subjective sensations (itching, burning) allow us to establish a diagnosis. Wide warts (vegetative papules) arise from erosive papules located in the area of the labia majora and on the skin adjacent to them, in the anal region, intergluteal and inguinal-femoral folds, armpits, interdigital folds of the feet, navel, scrotum, inguinal-scrotal folds at the root of the penis. These papules, under the influence of prolonged irritation, can vegetate, their surface becomes bumpy, uneven, covered with a serous or grayish sticky coating, containing a large number of pale treponemas.
Vegetating papules, or wide warts, tend to grow and sometimes reach large sizes. Wide condylomas are mainly characteristic of secondary recurrent syphilis and at a certain stage may be the only manifestation of the late period of the disease.
Miliary papular syphilis is extremely rare. Mostly on the skin of the trunk, grouped brownish-reddish or copper-red, conical, the size of a poppy or millet grain, dense papules appear. When grouped, the rashes form rings, arcs, plaques with jagged edges and a fine-grained surface. The nodules are located around the mouths of the sebaceous hair follicles. On the surface of individual papules there are scales or horny spines. Sometimes miliary papules are so pale and small that miliary syphilis can resemble the so-called goose bumps.
Abundant miliary syphilis indicates a severe course of syphilis.
Differential diagnosis. Lenticular syphilis can be very similar to lichen planus, parapsoriasis, and lichen scaly. However, with lichen planus, in contrast to papular syphilis, flat shiny, polygonal livid colors appear, with an umbilical depression in the center of the papules. Due to uneven granulosis, a grayish-white mesh (Wickham mesh) is determined on the surface of the papules. Usually the process is accompanied by severe itching.
Clinically, the drop-shaped form of parapsoriasis can be very difficult to distinguish from syphilitic papules, however, with parapsoriasis there is a triad of symptoms characteristic only of this disease: latent desquamation, revealed when scraping the rashes; the symptom of "cachet" (LN Mashkillayson), that is, peeling revealed by scraping has the form of a colloidal film; and hemorrhages around the papules that occur when scraping the latter. In addition, rashes with parapsoriasis are accompanied by less infiltration compared to syphilitic nodules and extremely rarely appear on the oral mucosa.
Scaly lichen differs from psoriasiform papular syphilis by the presence of the phenomena of stearin spot, psoriatic film and punctate bleeding, characteristic of psoriasis, peripheral growth and a tendency to fusion with the formation of plaques, a chronic course with frequent relapses. In addition, psoriatic eruptions are characterized by a pink color.
Wide condylomas may resemble genital warts, and when located in the anus, with hemorrhoids.
Genital warts differ from wide warts in a lobular structure, reminiscent of cauliflower, by the presence of a thin stem. Genital warts have a soft consistency, including in the area of the base of their legs, of various sizes, sometimes reaching the size of a cherry or more, the color of normal skin or pinkish-red, they often bleed easily.
Due to the fact that genital warts are localized in the genital and anal region, their surface can be macerated and eroded.
As for the hemorrhoids, in contrast to the wide warts, which are located on the skin with all their bases, the hemorrhoid has at least one surface of it covered with the rectal mucosa. In addition, the hemorrhoid has a soft consistency, often bleeds, and does not have a dense elastic infiltrate. It is necessary to take into account the chronic nature of the course of hemorrhoids, as well as the possibility of syphilitic rashes on hemorrhoids.
Miliary syphilis resembles lichenoid tuberculosis of the skin, which, unlike syphilitic papules, is characterized by a soft consistency, yellowish-red color, a tendency to clustering, the formation of tender scales on the surface of rashes, the onset of the process mainly in childhood, positive tuberculin reactions, the absence of other signs syphilis and negative serological reactions to syphilis. All these signs allow a correct diagnosis to be made.
When carrying out the differential diagnosis of papular syphilis, serological examination of patients for syphilis is of paramount importance.
Pustular (pustular) syphilis is a relatively rare manifestation of secondary syphilis. Its presence usually indicates a severe, malignant course of the disease. The appearance of pustular syphilis is often accompanied by fever and general symptoms. It occurs, as a rule, in debilitated, emaciated patients suffering from alcoholism, tuberculosis, drug addiction, hypovitaminosis, etc.
There are the following clinical varieties of pustular syphilis: acne-like, smallpox, impetiginous, ectymatous (ecthyma syphilitic), rupioid (syphilitic rupee).
Superficial pustular syphilides, such as acne-like, smallpox and impetiginous, more often occur in patients with secondary fresh syphilis, and deep pustular syphilides (ectymatous and rupioid) - mainly during relapses of the disease. Pustular syphilides are ordinary syphilitic papules, the infiltrate of which is saturated with serous-polynuclear exudate, disintegrates, after which a yellowish-brown crust similar to pyoderma is formed. In this case, the varieties of pustular syphilides are due to the localization, size and degree of their decay.
Acneiform (acneiform) pustular syphilide represents follicular papules sharply delimited from healthy skin, at the apex of which there is a pustule 0.2-0.3 cm in diameter in a conical shape. The purulent exudate quickly dries up into a yellowish-brownish crust, after which, after falling off, barely noticeable depressed pigmented scars are revealed. Acneiform syphilis is usually combined with other manifestations of the secondary period of syphilis.
Differential diagnosis. Differentiate acne syphilis with acne vulgaris, papulonecrotic tuberculosis and iodine or bromide acne. Common acne differs from acne-like syphilis in the acute nature of inflammation, soreness, the presence of severe seborrhea and comedones, the age of patients, a chronic course with frequent relapses of rashes. Papulonecrotic tuberculosis of the skin, localized on the extensor surfaces of the extremities, proceeds for a long time, the elements develop torpidly, and at the site of nodular eruptions that undergo necrosis of the central part, "stamped" scars remain, which never occur with syphilis. In the diagnosis of iodine and bromous acne, in contrast to syphilis, the presence of large pustules, an acute inflammatory corolla along the periphery of acne-like elements is important; absence of dense infiltration at the base, rapid resolution of rashes after stopping the administration of iodine or bromine preparations.
Smallpox pustular syphilis It is a hemispherical pustule the size of a lentil or a pea, surrounded by a sharply delimited copper-red infiltrate with an umbilical depression in the center. After 5-7 days, the contents of the pustule shrink into a crust located on the infiltrated base, and in this form the element is kept for a long time. After crust rejection, brown pigmentation and often a scar remains. Ospenoid syphilis can appear in any quantity, but more often up to 15-20 elements usually appear on the flexor surfaces of the limbs, trunk, face.
Differential diagnosis. Smallpox syphilis must be distinguished from natural and chickenpox. An acute onset with a high body temperature, a severe general condition of the patient, the absence of a dense infiltrate at the base of pustules, the appearance of rashes first on the face, negative serological reactions make it possible to reject the diagnosis of smallpox syphilis.
Impetiginous pustular syphilis begins with the formation on the skin of the face, flexion surface of the upper extremities, chest, back of dark red papules of dense consistency, often up to 1 cm in diameter, less often - more. After a few days, thin-walled pustules form at the top of the papules, which quickly shrink, forming massive, towering, layered yellowish-brown crusts surrounded by a dark red infiltrated corolla. When the crusts are forcibly removed, a dark red, easily bleeding ulcer is exposed.
Differential diagnosis. Vulgar impetigo differs from syphilitic acute onset, rapid spread, the formation of first flicken without compaction at the base, the presence of golden or dirty gray crusts, when removed, a smooth, moist, bright red erosive surface is exposed, "screenings" around the periphery and merging of rashes into large foci irregular outlines. Mostly children are sick.
Ectymatous pustular syphilis is a severe malignant form of pustular syphilis and usually occurs after 5-6 months. after infection. An important feature of ecthyma is the tendency of the element to decay both inward and outward. There is a delimited dark red infiltrate, in the center of which a pustule is quickly formed, drying up into a dense, as if depressed, grayish-brown, almost black crust, surrounded by a copper-red infiltrate. Ecthyma gradually increases due to peripheral growth, reaching the size of a 5-ruble coin and more. After removal of the crust, a more or less deep ulcer is exposed with steep edges and a smooth bottom, covered with yellowish-gray necrotic masses with purulent discharge. The ulcer is surrounded by a dense, sharply demarcated, dark red infiltrated ridge. After the ecthyma heals, a pigmented scar remains.
What is syphilis
Syphilides are signs of skin lesions, as well as mucous membranes, resulting from syphilis. Basically, such symptoms are observed in patients with secondary forms of syphilis. Outwardly, syphilides are round formations in the form of spots, round in shape, have a pinkish-red color with a bluish tinge, their size is similar to the size of a 15-kopeck coin. There are no elevations above the surrounding skin, there is also no tendency to perifocal growth, the spots do not peel off and usually disappear when pressed on them. Syphilides are located mainly on the lateral parts of the body, on the abdomen, chest, on the upper and lower extremities, as well as on the hands and feet. There are cases of the location of syphilides on the patient's genitals, but there they are much less noticeable. Very often they appear on the mucous membranes of the oral cavity. After appropriate treatment, syphilides disappear without a trace on the fifth week of treatment.
Types of syphilis
There are several main types of syphilis known to medical science.
Primary syphilis
Primary syphilis is solid and round in shape, located on the mucous membranes and on the skin, subsequently it develops to the state of regional lymphangitis and lymphadenitis. In the event that primary syphilides are localized on the head of the male genital organ, balanoposthitis and phimosis develop. Various severe complications, the occurrence of gangrene is also real. Detection of primary syphilis (chancre) is essential for the diagnosis of primary syphilis. In addition, the diagnosis requires a primary history, detection of white treponemas, as well as positive results of ongoing serological studies. For the purpose of treatment, penicillin preparations are used.
Secondary syphilis
Secondary syphilis is the most common secondary form of syphilis. Secondary syphilides can be lenticular, small papular, miliary and large papular. Most often they have a rounded shape, their outlines are clearly delineated, the diameter, as a rule, does not exceed half a centimeter. Papules do not grow on their periphery and do not merge. They are pink in color, gradually taking on a copper-red color. They peel off closer to the center and the peeling ends closer to the periphery.
Tertiary syphilis
Tertiary syphilides occur in the tertiary period of the disease, in which there is a lesion of the mucous membranes of the nasal cavity and pharynx. In the case of damage to the nasal cavity, the process usually moves on the bones, there is a retraction of the nose, it takes a saddle shape.
The appearance of tertiary syphilides causes perforation of the nasal septum in the bone region. It is they that cause the development of perforation, concentrating on the soft and hard palate. In such cases, food gets into the nose when eating.
There are the following main types of syphilis.
Papular syphilis
Most often, papular syphilis is a manifestation of a secondary type of syphilis, in extremely rare cases it becomes possible to simultaneously occur with the primary stage of the formation of a roseolous rash. Papules are the appearance of inflammatory elements in the skin dermis, in addition, they mainly protrude above the skin surface and have the form of oval or rounded seals. They live no more than one or two months. After that, papular syphilides dissolve, leaving behind a zone of increased pigmentation.
Tuberous syphilis
Lumpy syphilis is the most common form of the tertiary clinical form of syphilis. Most often, it is observed in the third year of the disease, in more rare cases, it may appear in the second or first year. It is extremely rare that such syphilis appears decades after a person is infected. The tubercle is a formation that rises above the skin, with a bedding in the dermis at some depth. The diameter of the formation reaches several millimeters. The color of this type of syphilis can be bluish or purple-red. Lumpy syphilides are poured out on separate skin areas, there is no fusion between them. After a few months, they either dissolve or ulcerate.
Roseolous syphilide
This type of pathology is the most common, its appearance appears as a consequence of the spread of infection throughout the body of a sick person. Syphilides have the appearance of pale pink spots characteristic of inflammatory processes with a rounded shape and blurred outlines. Roseola does not exceed several centimeters in size, their surface is smooth, does not protrude above the skin. The formations do not merge, they are located mainly on the sides of the sick person, as well as on his back.
Pustular syphilis
Pustular syphilides are the least common among all other varieties. They develop exclusively on papular infiltrates. Their appearance is accompanied by the appearance of edema, abscesses, as well as additional formation of leukocytes.
The appearance of syphilides of this type is a consequence of a decrease in the general resistance of the body to the disease that has arisen. Their combinations with the atypical form of syphilis are possible. Malignant forms of pustular syphilides are comparatively rare, their form is not pronounced.
Gummy syphilide
Gummy syphilide is a kind of node that occurs as a result of the development of infectious granulomas in the subcutaneous tissue, and in more rare cases in muscles or bones. At the initial stages, in the depths of the affected areas, a zone of inflammation was formed, outwardly dense and without pronounced signs of the course of the inflammatory process. You can only find it by chance. When probing with fingers, a zone of sufficient density and elasticity is formed, which looks like a ball. The gummy syphilis node is shaped like an egg or hazelnut. The skin surface above it is completely normal.
Pigmented syphilide
Pigmented syphilis is a sign of the development of a secondary form of recurrent syphilis. The location of this type of syphilide most often takes place on the chest, neck of the patient, and, in some cases, on his back.
In these areas, the formation of white spots, approximately the same in size, takes place. The size of such spots does not exceed a pea, they are surrounded by a border of the skin surface with enhanced pigmentation. The shape of the affected area may externally resemble lace or mesh. Anti-syphilis treatment for such spots is very weak and they are able to persist for a long time. In the initial stages of the onset of such syphilides, specific baldness and leukoderma are noted. This most often occurs when the nervous system is affected by syphilis, which is confirmed by ongoing studies.
Acne syphilis
Acne-like syphilides at the time of their occurrence are often surrounded by areas with an acute stage of inflammation. After a few days, the rash turns bright red. Basically, acne-like syphilides are located in the scalp, and can also appear on the patient's forehead, back or chest. Syphilides are on the skin for a very long time and their manifestation is subject to a certain cyclicality. Depending on the stage of development of the disease, its symptoms change, as well as the size of the syphilides themselves. The extreme form of the development of the disease is accompanied by the acquisition of copper-colored syphilides. It lasts until the formation of hard crusts on them, after which they fall off, a trace of the corresponding pigmentation remains on the skin.
Other types of syphilis
Among the other, most famous varieties of syphilides, the plantar-palmar view should be distinguished. Such syphilides can be characterized by the appearance of formations, similar to nodules, which have a clear restriction with the surrounding surface of the skin. The surface of the rash is smooth, their color is mainly pale pink, less often reddish-brown or reddish-purple. The period of the most rapid development of such syphilides is characterized by their desquamation and cracking. Very often, patients confuse the occurrence of such syphilides with ordinary calluses and do not attach importance to them. In this case, the disease is essentially triggered.
Syphilis how to treat?
Treatment of syphilides is carried out on the basis of taking into account all the factors that determine the patient's susceptibility to this disease. The current stage of the patient's course of the disease is also important. The early onset of syphilides is much easier to treat, the weeks are late, advanced stages.
There are two main methods of treatment: permanent and variable, which is accompanied by the intake of drugs prescribed by the doctor. During treatment, you should also pass all the mandatory tests, as well as monitor the condition of the sick person.
The basis for the treatment of syphilis is complex therapy, which includes:
- taking antibiotics;
- the use of fortifying agents, immunomodulators, vitamin complexes, as well as proteolytic enzymes;
- taking dental drugs, which are pain relievers, anti-inflammatory drugs and hematoprotectors.
When treating, it is imperative to prescribe an appropriate diet, containing increased doses of protein components, as well as a limited amount of fat. Sexual life, as well as the use of alcohol and nicotine are absolutely excluded.
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