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Secondary syphilis of the skin and mucous membranes

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The manifestations of secondary syphilis are extremely diverse. They have similarities with many diseases, which is why scientists who studied syphilis called it a "great monkey." A rash on the skin and mucous membranes, including the mouth, wide condylomas, syphilitic sore throat, leukderm and syphilitic alopecia (alopecia) are the most common of them.

Syphilitic Alopecia

Syphilitic alopecia (pathological hair loss) occurs in secondary syphilis in 15–20% of cases. In some patients, loss of eyelashes, hair, eyebrows, mustache and beard. This pathology occurs in both fresh (early) and recurrent syphilis. Often combined with leucoderma.

The cause of small focal syphilitic alopecia is a malnutrition of the hair that has developed as a result of inflammation caused by pale treponema. The cause of diffuse syphilitic inflammation is considered to be intoxication, a disruption of the endocrine and nervous systems, resulting from exposure to syphilitic infection. In all forms of alopecia, the hair follicle is not damaged, therefore after 1 - 2 months after adequate treatment, the hair grows back.

With small focal alopecia the patient has many small round-shaped centers of baldness on the entire head, but the greatest number of them is recorded at the temples and in the neck. Due to the fact that in the affected areas, hair does not fall out all, the pockets of alopecia resemble fur, eaten by moths. The skin is not inflamed. Peeling and itching absent.

With diffuse alopecia the hair begins to fall out from the area of ​​the temples and then the process spreads over the entire scalp of the head, which is observed in some severe acute infectious diseases.

With mixed alopecia there is a combination of the two above described forms of the disease.

Eyebrow hair drop out by the type of small foci of alopecia (omnibus syphilide).

Eyelashes fall out and grow unevenly, with the result that they have unequal length (stepped eyelashes, a sign of Pincus).

Syphilitic alopecia should be distinguished from nesting baldness, superficial trichophytosis, microsporia, favus, early baldness, lupus erythematosus, lichen planus.

Fig. 3. Melkoochagovaya syphilitic alopecia - a sign of syphilis of the secondary period.

Fig. 4. Syphilitic alopecia in men.

Fig. 5. Symptom Pincus - step growth of eyelashes with syphilis and hair loss with syphilis on the eyebrows.

Nail damage to syphilis

  • The nails are affected in the second period of syphilis, more often in patients with pustular syphilide. This pathology is rare. With the disease affects both the nail itself and the periungual roller.
  • The defeat of the nail roller begins with the appearance of papules or pustules. They are located on the nail shaft in isolation, but sometimes merge. The clinical picture is reminiscent of felon. Papules are red with a bluish tinge. Inflammatory reaction is expressed significantly. Sometimes an abscess develops, which eventually ulcers.
  • Syphilitic lesion of the nail plate develops slowly. The nail dims and thickens, acquires a grayish-dirty color, begins to crumble. On it appear transverse and longitudinal cracks. Sometimes the nail dies completely and is rejected. Even without treatment, a normal nail plate grows after a few months. Under the influence of a specific treatment, a normal nail grows faster.
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Short description

Against the background of secondary skin manifestations, early visceral lesions can develop - cardiovascular syphilis, hepatitis, gastritis, etc., and lesions of the musculoskeletal system (night pains in the long tubular bones of the limbs, synovitis, osteoarthritis).

I. INTRODUCTORY PART

Protocol name: Secondary syphilis of the skin and mucous membranes
Protocol code:

A51.3 Secondary syphilis of the skin and mucous membranes

Abbreviations used in the protocol:
AMP - Antimicrobial Agents
intramuscular injection
g - gram
ED - units of action
ELISA - enzyme immunoassay
DAC - serological reaction complex
INN - international non-proprietary name

RW - Wasserman reaction

Protocol Development Date: year 2014.

Patient category: adults, children.

Protocol users: dermatovenerologists, gynecologists, urologists, general practitioners, general practitioners, pediatricians.

Diagnostics

Ii. METHODS, APPROACHES AND PROCEDURES FOR DIAGNOSTICS AND TREATMENT

- Ultrasound of the pelvic organs.

- Hepatitis test - B, C.

Diagnostic measures carried out at the stage of emergency first aid: not held

- whether there are minor children in the family.

the elements are larger, less abundant, often asymmetrical, prone to grouping (the formation of figures, garlands, arcs), of a paler color. They are often located on the body, scalp, face, upper and lower limbs, palms and soles, in the perineum, inguinal folds. On the mucous membranes of the genital organs, the mouth, i.e. in places subject to irritation. More common papular rash. There are enlarged lymph nodes, consistency of mobile, elastic, painless (axillary, submandibular, cervical, cubital). Possible residual effects of primary syphilis, damage to internal organs and systems.

- Statement of RPHA with the antigen of pale treponema in blood serum: positive results.

Syphilitic roseola mucous membranes

Syphilitic roseola in the oral cavity is located isolated, or the spots merge, forming continuous areas of hyperemia in the tonsils (syphilitic tonsillitis) or the soft palate. The spots are red, often with a bluish tinge, sharply delimited from the surrounding tissue. The general condition of the patient suffers rarely.

With the localization of roseol in the nasal passages, dryness is noted, sometimes crusts appear on the mucous membrane. On the genitals, syphilitic roseola is rare, always subtle.

Papular syphilide mucous membranes

Most often with syphilis papular syphilide occurs. Papules on the mucous membranes have a dense base and a dense texture, rounded, smooth, flat, with clear boundaries, rich red color, the patient is not disturbed. Due to constant irritation, their central part macerates and acquires a whitish-gray or yellowish tint. Papillary growths appear on the surface. Papules are prone to hypertrophy. When they merge, rather large plaques are formed, which have clear boundaries and scalloped edges.

The mucous membrane of the oral cavity, gums, tongue, lips, corners of the mouth, genitals, anus, are the main locations of papules. Less commonly, papules are located on the mucous membrane of the pharynx, nose, eyes, and vocal cords.

In some cases, patients with secondary syphilis on the mucous membranes appear erosive-ulcerative syphilide. Such papules are often located on the tonsils and soft palate.

Papules in the corners of the mouth are often crusted, cracked and resemble bunches. Papules on the back of the tongue look like oval, devoid of papillae, of a bright red color of formation ("a symptom of a mowed meadow").

Papules may appear on the mucous membrane of the larynx. With the defeat of the vocal cords marked hoarseness. With a common process, a complete loss of voice (aphonia) develops.

Papular syphilide nasal mucosa occurs according to the type of severe catarrhal inflammation.

Papular syphilide of the oral cavity should be distinguished from banal tonsillitis, diphtheria, lichen planus, aphthous stomatitis and flat leukoplakia.

All elements of the syphilis rash are extremely contagious. The greatest danger of papular syphilide of the oral cavity is for dentists.

Fig. 6. Syphilis in the mouth - papular syphilide of the tongue.

Fig. 7. Syphilis in the mouth - papular syphilide in the corners of the mouth and on the hard palate.

Pustular syphilide mucous membranes

Pustular syphilide mucous membranes is rare. The development of the disease begins with the appearance of diffuse infiltration, which eventually disintegrates with the formation of a deep painful ulcer. The bottom of such an ulcer is covered with pus. The process is accompanied by indisposition of increased body temperature.

All erosive-ulcerative processes with localization on the mucous membranes should be subjected to examination for the presence of pale treponemas.

Syphilitic angina

Syphilitic tonsillitis is one of the manifestations of syphilis in the mouth. When syphilitic roseola in the area of ​​the tonsils and lymphoid ring spots appear, which can be placed both separately and merge, forming solid areas of hyperemia (syphilitic angina). The spots are red, often with a bluish tinge, sharply delimited from the surrounding tissue. The general condition of the patient suffers rarely.

In secondary syphilis, papular tonsillitis is more common. Papular elements are prone to peripheral growth, often coalescing to form plaques with clear boundaries. At ulceration papules become covered with a whitish bloom. With the defeat of the mucous membrane of the throat, pain is noted when swallowing. Ulcerated papules are always accompanied by pain. The general condition of the patient is deteriorating. There is an increased body temperature.

Fig. 8. Syphilis in the mouth - syphilitic tonsillitis: syphilitic roseola (left photo) and papular syphilide (right photo).

Fig. 9. Syphilis in the mouth - syphilitic tonsillitis.

Signs of syphilitic lesions of the mucous membranes of the nose and oral cavity, pharynx and larynx:

  • the disease proceeds without marked inflammation,
  • painlessness
  • the course of the disease is long,
  • resistance to anti-inflammatory traditional therapy is noted,
  • tests for syphilis are often positive.
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The defeat of the osteo-articular apparatus

Bones and joints are affected at the end of the primary period of syphilis, but more often lesions are recorded in the secondary period. Pain is the main symptom of the disease. There are pains in the lower limbs in the area of ​​the long tubular bones, knee and shoulder joints. Hydroarthrosis, periostitis, and osteoperiostitis occur.

Nervous system damage

In the early stages of syphilis, there is inflammation of the membranes of the brain and blood vessels (often latent meningitis, meningovascular neurosyphilis), and the work of the autonomic nervous system is impaired.

On the manifestations of secondary syphilis on the skin read article

Read more about the diagnosis and treatment of syphilis in the article.

Types and forms

Doctors distinguish between three types of syphilitic alopecia:

  • Diffuse starts from the temples and to the disease itself syphilis is difficult to bind. There are practically no characteristic signs by which the diagnosis could be determined. Manifestation of the disease only after syphilis or during the inactive phase.

  • Melkoochagovaya alopecia begins with the occipital and temporal areas, pockets the size of one or two coins, irregular shape. Hair falls out incompletely, but it can affect not only the head, but also other hairy areas - eyebrows, mustaches, and wiry hair.

  • Mixed alopecia is a combination of the first two types. The beginning of baldness occurs spontaneously and rapidly. If we start the necessary treatment in time, then the loss will stop and then the hair covering on balding sites will be restored.

Note! Of all the types of syphilitic alopecia, doctors consider the mixed type the most dangerous and difficult to treat.

Manifestation of syphilitic alopecia begins with the temporal lobes of the head. Distribution gets pretty fast. It looks like ordinary baldness with severe toxic intoxication, but in fact everything is not so harmless. Such baldness arises unexpectedly, dramatically progresses.

If the main disease (syphilis infection) is treated, then in two weeks the hair stops falling off, after the infection is eliminated, hair growth is gradually restored and within 2–3 months the bare areas grow over with new hair.

Also among the signs include: the rapid spread of bald patches all over the head, the difficulty of diagnosing syphilis during this period, the visible cessation of strands falling out 10 days after the infection of the body.

Treatment methods

In the treatment of syphilitic alopecia, the main task is to overcome the underlying disease, and then to achieve normalization of hair growth.

Doctors recommend a course of vitamin therapy, which will gradually restore the hair. The courses are long, with short breaks, if necessary with the change of the complex. Applying Pyrogenal in the treatment, the dose is gradually increased, bringing to 15 mg.

Corticosteroid ointments and drugs taken orally act effectively. Modern corticosteroid drugs act on specific areas that are to be treated. The mechanism of their action is reduced to the neutralization of prostaglandins, which provoke inflammation in the body. However, there are contraindications to their use: tuberculosis, diabetes, potassium insufficiency, renal diseases, hypertension.

The doctor may prescribe the following drugs:

  • Dermoveit. It includes strong hormonal components, acts quickly, is used to stop the process, then alopecia is treated with easier means. The cost is about 420–540 p.

  • Fluorocort. Glucocorticosteroids in the composition of the ointment does not allow to use this tool during pregnancy, breastfeeding, before 18 years. Acts on all types of alopecia, improves vascular permeability in the area of ​​baldness, helps to establish a metabolism, nutrition of hair follicles. Price 260-350 p.

  • Advantan. The active substance is prednisone. The drug relieves allergies, peeling, swelling, itching, eliminates inflammation. Moisturized dry skin. Price within 650–1300 p.

  • Belogent. Ointment with gentamicin and betamethasone. Suppresses inflammatory processes, establishes a healthy metabolism in the affected areas of the skin. The cost of the drug is about 250-450 p.

  • Beloderm. Corticosteroid drug with antiproliferative and antihistamine effect. It constricts blood vessels, relieves discomforting symptoms of syphilitic alopecia, and other skin diseases. No side effects. Price 270-300 p.

  • Hydrocortisone. Eliminates inflammatory processes at the site of application, there may be side effects if a virus is present in the body or a fungal infection develops. The cost of about 120 p.

  • Lokoid ointment with hydrocortisone, quickly removes inflammation, relieves itching, allows hair bulbs to recover. Price about 350 p.

  • Lorinden. Neutralizes the causative agents of bacterial and fungal infections. The cost of about 400 p.

Also, the positive dynamics is observed in the treatment of physiotherapy methods: darsonval, ultrasound, various currents.

Tip! Holders of long hair is best to have a short haircut. It helps to reduce the weight of the hair - they do not fall out so much, the blood flow to the roots increases, which helps with nutrition and oxygenation.

Rules of care during treatment:

  • Shampooing daily or every other day to prevent the sebum from clogging up the pores.
  • With combing the hair, it is worth being careful, the skin of the head is affected as little as possible. Never press the teeth too hard.
  • Caring means to cancel, except those prescribed by a doctor, as excessive chemistry irritates the skin and provokes dandruff, spoils the hair structure.

Prevention

Timely diagnosis, follow-up care for serious infectious diseases, regular monitoring and control of syphilitic infection during the inactive phase, can prevent baldness.

Syphilitic alopecia is dangerous in cases where the main disease is not treated. With proper and systematic treatment, the chances of a complete cure are maximum. It is possible to restore the lost hair in six months, however, the strands will lose elasticity, become brittle and thin.

On average, a complete cure and getting rid of infiltration is possible in 3-5 months, and after a while the balding walls accompanying the disease disappear.

Types and symptoms of this disease

In our time, syphilitic baldness is divided into 3 types:

  1. Small focal. In this case, baldness accounts for the region of the temples and occiput, creating small pockets of loss on them. The width of one such area is only 1-2 cm, while its shape is irregular. The foci themselves are scattered in different places that are not in contact with each other. It is important to note that the head of hair with small focal alopecia falls partially. In addition to hair loss, many patients notice the thinning of the mustache, beard and body hair.
  2. Diffuse The beginning of this type of alopecia is the temporal region, after the defeat of which the prolapse passes to the main part of the head. This type of pathology has no characteristic signs that could be compared with syphilis. The disease clearly begins to manifest itself only after the transfer or lull of a dangerous infection.
  3. Mixed This species combines both previous forms of alopecia, in which baldness begins quickly and suddenly.With proper treatment, hair growth resumes 2 months after the complete infiltration. This form of the disease is considered the most dangerous and difficult to cure.

The symptoms of the above types of syphilitic alopecia include:

  • The rapid spread of baldness throughout the base of the head.
  • Lack of syphilitic signs.
  • Habitual to all loss with different foci of baldness.
  • Difficult diagnosis due to syphilitic infection.
  • Termination of loss after 10 days, after the spread of infection in the body.

With proper and timely treatment, hair is fully restored after 6-8 months, but strands can become more brittle and thin.

Therefore, it is important to consult a doctor in a timely manner in order to begin eliminating the causes of baldness and conduct a comprehensive treatment for hair loss.

During the diagnosis, a specialist will identify microsporia and other infectious pathologies of the scalp, and also exclude the scar degree of alopecia, which recurs without treatment. These measures are necessary in order not to aggravate the development of baldness, but to accurately identify the cause of hair loss.

When manifestations of relapse, doctors recommend cutting the hair as short as possible, thereby:

  • Reduce pressure on hair follicles.
  • Increase blood flow to the roots.
  • Accelerate the movement of blood in the affected areas of the scalp.

On average, treatment of this type of alopecia is carried out for 3-8 months, during which it is possible to completely overcome the infiltration, as well as to resume hair growth.

Treatment of syphilitic baldness

In the treatment of this disease, the patient should take a course of vitamins that will heal the hair roots and normalize the growth of the strands. Currently, oral medications, creams and ointments are used to remove the infiltrate. Also, physiotherapy, ultrasound and other currents, which are prescribed by doctors with a large number of pathologies for hair loss, also provide a quick therapeutic effect.

During treatment, it is important to strictly follow the recommendations of the doctor, as well as some rules for hair care:

  • To wash your hair is 1 time in two days, so that sebum does not clog the skin pores.
  • Combing hair is recommended infrequently, while not tearing the skin, and not strongly pressing the teeth on the affected areas.
  • It is not recommended to use hair care products, as they irritate the scalp and clog the hair structure with chemical components.

Syphilitic alopecia is a dangerous disease with unpleasant consequences. Therefore, it is important to start treatment in time to keep healthy and well-groomed hair.

Causes of Dry Skin

Dry skin causes a violation of the functions of the sebaceous glands. They produce less fat than is necessary for the formation of a natural protective film on the skin. This film of sebum and sweat makes the upper layer of the epidermis elastic and protects the skin from the harmful effects of the environment. When the glands produce little fat, the horny layer is loosened and the skin quickly loses moisture. Lack of fat and moisture contributes to the appearance on the skin of the face and body of wrinkles and scales. The fact that the sebaceous glands work more slowly with age is quite normal. For many people, in adulthood, the skin becomes more dry. However, dermatologists are concerned that dry skin is increasingly appearing in young people, even in the five or ten years of age. They blame the environmental degradation. ”,“ You have normal skin. This type of skin is relatively rare and usually in young people. On average, only 6-8 percent of adult women have normal skin. This skin is full of virtues. The natural acid mantle, sebaceous glands and blood circulation function perfectly. Normal skin is clean, elastic, stretched, without red spots or inflamed areas. The first wrinkles on such skin appear only after thirty-five years. A twice daily cleansing of the skin should become a habit. You're lucky - your skin tolerates any cleanser, even a simple soap. After washing for disinfection, “blot” the skin with a lotion or tonic for the face. ”“ You have oily skin. Oily skin always gives women a lot of trouble. Acne and acne often appear on it. It is covered with a film of fat and poorly supplied with blood. Most often, this type of skin is found in young girls during puberty. However, about 10 percent of adult women also suffer from active sebaceous glands.

Causes of oily skin

The sebaceous glands of this type of skin work more intensively than usual and secrete a lot of sebum. Blame for this the hormonal system, namely, the male hormones testosterone. They activate the sebaceous glands. The outer, horny layer of oily skin is also thicker. The pores of the skin are clogged with traffic jams and sebum does not come out. As a result, acne and acne appear on the surface. Oily skin is always more inflamed. The only consolation is that oily skin stays young longer. Sebum covers the skin with a natural protective film that protects it from the harmful effects of the environment. In women with oily skin, wrinkles appear much later than in others. ”,“ You have a mixed (combined) skin type. These are two different types of skin on the face - dry and oily. On the so-called T-shaped zone - on the central parts of the forehead, nose, chin - oily skin. On the cheeks - very dry. The difference between them is so big that you need different care products. Cosmetics for oily, inflamed skin are suitable for the T-shaped area, for cheeks - means for dry.

Causes of mixed skin

In the area of ​​the chin, nose and forehead, that is, in the T-shaped zone, there are more sebaceous glands than in the cheeks. The sebaceous glands in these areas secrete excess sebum, which is deposited on the surface in the form of a greasy film. The reason for this male testosterone hormones, stimulating the sebaceous glands. Small consolation: pronounced mixed skin in most cases is found only in girls and young women. After thirty years, the secretion of sebum in these areas is normalized and the skin type changes. ”,“ You have mature skin. Mature skin occurs in many women after forty years. It is rather dry, small and deep wrinkles, folds appear on it. The areas around the eyes and mouth, as well as the neck, are aging especially quickly. They need consistent care, then you can slow down the aging process by at least a few years.

Causes of Mature Skin

With age, wrinkles appear on the skin and it becomes more lethargic. This natural aging process has several causes.

  • First: the rate of work of the sebaceous glands decreases, as a result, the skin surface is deprived of effective natural protection.
  • Second, the collagen fibers inside the skin gradually lose their ability to absorb moisture and elasticity, as a result the skin is not able to accumulate as much moisture as before.
  • Third: the blood supply to the skin deteriorates and the upper layer no longer looks so elastic and pink.
  • Fourth: reduced production of new cells. In addition, instead of 28 days, it takes an average of 40 cells to reach the surface of the skin.

So, with age, the skin becomes thinner and, therefore, the barrier against the harmful effects of the environment - less durable. Now, thanks to proper care, aging can be slowed down for several years. In adulthood, factors such as nutrition, sleep, rest are even more important. ”“ You have sensitive skin. In Europe, almost every third woman finds her skin sensitive. The typical symptoms are probably familiar to many: a feeling of tightening of the skin, increased irritability of certain areas, red spots and spots. For skin cosmetics such skin reacts completely unpredictable. Today, she normally carries the tool, and tomorrow from it may appear red spots. Sensitive skin is quite annoying and stress, fatigue.

Causes of sensitive skin

This type of skin is rather dry by nature, that is, the sebaceous glands secrete little fat. As a result, the stratum corneum is very thin and does not sufficiently protect against external influences. Through it freely penetrate harmful substances. Blonde with fair skin, which lacks protective pigmentation, most often suffer from sensitive skin. Dermatologists blame skin hypersensitivity and external factors such as air pollution, stress, and cosmetics. Many women feel that their skin is sensitive due to allergies. However, this is not quite true. Here, only external symptoms are identical. According to experts, allergies are only considered when the immune system is affected. This is determined by a blood test. Allergies are recognized by the following signs: it never appears spontaneously, that is, it never appears immediately after applying the cream. An allergic reaction appears on the skin at the earliest in three to five hours. In contrast, sensitive skin will immediately react to an inappropriate new cream. ”],

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The main methods of treatment

In case of leukopathy, it is important to constantly be observed by a venereologist. The main type of treatment is Penicillin, and local preparations are also used. The dosage is selected individually for each. The main task is to constantly maintain the necessary dose of antibacterial drugs in the blood.

It is very important to introduce potent drugs at the beginning of the development of the disease every 3 hours. It is especially dangerous when another rash appears, it says that the person is also infected with another virus.

In addition to the appointment of potent drugs, it is necessary to take immunomodulators, vitamins, minerals, dietary supplements, which enhance immunity, remove harmful microorganisms.

When the disease proceeds in a complex form, it is necessary to inject intramuscularly with special drugs, antibiotics. With their help, you can dry, disinfect the skin, get rid of erosions, ulcers on the body.

It is important to constantly monitor the patient's condition. If the first scheme is unsuccessful, it is adjusted, while changing drugs, their dose. In addition, the patient must comply with the diet, completely abandon all bad habits.

Drugs need to be taken by two partners, after treatment it is imperative that you pass all tests. In case of aggravation, undergo a repeated course of therapy.

Symptoms of syphilis in men: signs and how it is transmitted

This is one of the most dangerous sexually transmitted diseases, which, fortunately, is quite rare and is rarely asymptomatic in men. Most often, it is sexually transmitted and only in rare cases can it be transmitted to the household. For example, if a person was sitting on the bench with the last stage of the disease or he used public transport. Therefore, experts do not recommend sitting on the beach on benches and sun beds, if they are not treated.

Like AIDS, syphilis is transmitted through the blood of an infected person. For example, when drug addicts use one syringe for several people, as well as from a sick mother to a child through blood. Most often this happens during unprotected intercourse, through any natural discharge of the body. Even if the partner appears to be healthy outwardly, chancre can form on her internal genital organs, in contact with which the man picks up the infection.

Symptoms of syphilis do not occur immediately after infection, but several weeks after the introduction of the pathogen. Usually the incubation period lasts from 3 to 6 weeks. Then at the site of infection appears hard chancre. So in medicine is called a round ulcer with a hard bottom, completely painless and does not cause any concerns.

Many people take her for herpes, but at this stage of the disease you should consult a doctor. The place of its appearance depends on the way in which a person became infected. Most often it occurs in the area of ​​the penis (on the head), in the corners of the mouth or on the hand, if a person has become infected through everyday life. A few days later the ulcer disappears, but the disease does not go away. However, chancre does not always occur in patients. Usually, the only sign of the disease at the initial stage is enlarged lymph nodes around the site of infection.

In men, an ulcer can appear not only on the genitals, but also on the abdomen, palms, buttocks, or on the hands, depending on the location of the infection. Usually at the initial stage there are no other symptoms. And only in rare situations a man may experience symptoms such as loss of strength, dizziness, and general malaise. Irritability may occur, a slight fever. Chancres is fast, so in the first stage of the disease, the man rarely goes to the doctor. But do not assume that the disease has passed by itself. After the symptoms subside, the disease will again remind you of its existence with more pronounced symptoms.

There are 3 stages of the disease. During the first at the site of infection appears an ulcer with a hard bottom (chancre), which after a few days passes without treatment. In the second stage, a rash spreads through the body, the characteristic symptoms of the disease appear, then disappear again. Well, in the third stage, the disease affects the entire body. Symptoms of damage to internal organs, the nervous system appear, people go blind, stall, and paralysis develops.

Skin rash in syphilis photo in the first stage

At the first stage of infection, an ulcer of the correct form and very hard, like cartilage or cardboard, appears. If you look at photos of syphilis at different stages of the disease, then it has different rashes. In the first stage, only the area of ​​infection is affected. That is why the most effective treatment is considered at the initial stage of the disease. If a man contracted sexually during genital contact with a sick woman or during anal sex, signs of the disease appear on the head of the penis or at its base.

In homosexuals who are addicted to oral sex, the mouth can become a place of infection. Very often, the first appearance of syphilis in these places appear in the corners of the mouth and resemble zadyed. However, unlike cracks caused by a vitamin deficiency, syphilitic ulcers do not cause scaling, are painless and have a very hard bottom. After a few days they pass and the disease moves to a new stage.

Since syphilis affects the entire human body, a phenomenon such as the necklace of Venus photo may occur. Or as it is scientifically called, syphilitic leucoderma. The literature describes a legend about it. Venus fell in love with a young man of extraordinary beauty who, after a night with the goddess of love, did not want to continue the relationship. Under the guise of a good old woman, she gave every girl with whom the boy slept, presented him with a red dress and a pearl necklace. And the youngest man was presented with a straw hat and a red shirt. When the magic was over, the beads of Venus turned into sores and ugly white spots. A straw hat on the head of a young man crumbled with his hair. Since then, it is believed that syphilis is the curse of Venus. Although in fact alopecia and Venus' necklace are not found in all patients with syphilis.

White spots of Venus do not cause any symptoms, look very ugly. They can be both white and yellow, and even brown, merge or be at a distance from each other. Differ spotty, marble and mesh structure. Most often, these spots appear on the neck, abdomen, face skin and even the feet and palms. The necklace of Venus appears after stage 2 of the disease, when other types of syphilitic lesions can appear. About them will be separately stated. One of the reasons - the defeat of the nervous system. It is also interesting that there is no causative agent of syphilis in the spots. And doctors still do not understand the reason why such spots appear on the skin in the neck.

How much does syphilis occur in men?

The incubation period is from 3 weeks to 6 or 7. After this period, a characteristic sore appears at the site of infection. Skin eruptions appear only in the second stage of the disease. It occurs a few weeks after the chancre disappears.

At the second stage, various rashes appear on the body, including characteristic such as Venus necklace, photo syphilitic roseola or many others, during secondary infection. The rash may be on the scalp or the genital area, on the abdomen, torso, palms and soles. Most often it is papules, leucoderma, roseola, chancre, bubbles on mucous membranes.

When syphilis on the skin of the feet and palms can appear red spots, which are located separately from each other. Через некоторое время они превращаются в язвы и исчезают, чтобы появиться вновь. При повторном появлении от них очень трудно избавиться и они могут не проходить несколько лет.

With rashes during syphilis, there is no itching, unlike many skin diseases. Even ulcers do not cause pain. They appear with a brilliant, as if polished bottom and smooth edges. Also, rashes, unlike skin allergic dermatitis, do not itch and do not merge with each other. The skin around the inflammation never inflames and does not swell. If treatment begins, the sores disappear quickly. But this is the cunning of the disease - the disease itself begins to go asymptomatically, affecting the internal organs. And the person does not notice how it goes into the third stage, when it is very difficult to help the patient. Indeed, often during syphilis, a person begins to smear ulcers with antibiotic gel, which complicates diagnosis. However, without taking special drugs for syphilis, it is impossible to get rid of, as it affects all organs and systems.

Roseola is a pinkish stain that resembles an allergy. They often appear on the body, do not itch. When pressed, roseola disappears, stains do not merge together.

Also, when syphilis appear papules. They look like nipples or lips bright red or brownish in color. Papules are on the back, stomach, around the mouth. They are solid and do not merge. Can change shape. Sometimes they are located under the arms and on the genitals.

And finally, during the third stage, round red spots may appear that look like coins. The content that is separated from them is very contagious, like other excretions during the illness.

Syphilitic rash photo in men on the head

In the first stage of the disease, a characteristic round-shaped ulcer with a flat bottom appears on the head of the penis or at its base. She is very hard and you can get infected if touched. After a few days, it disappears, and then various kinds of rash appear on the body of a person. Some people have large inflammations that look like white eels, located under the top layer of skin. They are painless and in contact with them you can get syphilis.

How and what to treat syphilis in men video

First of all, it is inpatient treatment in a medical institution with preparations containing penicillin. Continuous testing until indicators return to normal. No popular treatment for this disease can be performed. Those close to the patient should change the dishes, personal belongings, and also disinfect the house. Their health condition is monitored by the doctor and, if necessary, prescribed treatment. In addition to antibiotics during the disease, special substances are prescribed that activate the natural immunity. The length of hospital stay depends on the severity of the disease and the stage at which treatment began. Children born to mothers with syphilis, in some cases are subject to lifelong hospitalization.

Why does syphilis occur in the mouth?

The claim that syphilis is an exclusively sexually transmitted disease is not entirely true. The fact is that they can be infected in everyday life by directly getting an infection in the blood through scratches or wounds on the body, it is also possible with the use of toilet articles (towel, washcloth) belonging to the patient.

In addition, syphilis infection can occur through blood transfusions, can be syphilis and congenital. Mostly rash foci is located in the hair and step area, as well as on the palms.

In addition, in women it is also localized under the mammary glands, for both sexes, its concentration may be located in the region of the organs of the genitals.

After 3-4 weeks from the moment of infection, the place where the introduction of pale treponema, the causative agent of infection of the disease (which is mainly the genitals), occurred, becomes signs indicating primary syphilis.

In this article, we will examine the causes of treponema infection, the main symptoms at each stage of the disease and the methods of effective therapy.

In the mouth, the disease can manifest itself for several reasons.

    The patient visited a doctor with non-sterile devices and instruments. As a rule, this applies to specializations aimed at working in the oral cavity (dentists, ENT patients, infectious diseases doctors, therapists, etc.). Trionema is easily transmitted through blood, the remnants of which can be found even on medical instruments. Sometimes the microorganism enters the patient’s bloodstream due to an illiterate injection or operation, non-sterile syringes, scalpels, etc.

Oral syphilis

  • Occupational Illness. At the same time with the patient, a doctor (dentist, gynecologist, venereologist, therapist, etc.) who is in direct contact with a diseased syphilis may also be at risk. As a rule, the pathogen is transmitted through microcracks in the hands (the doctor does not wear gloves), or instruments and devices (did not undergo appropriate treatment after contact with syphilitic).
  • Intrauterine triponeme transmission. Unfortunately, some doctors allow a sick woman to give birth and do not conduct proper therapy, after which the baby is born with symptoms of syphilis in her mouth. Infection occurs intrauterinely through the mother's blood.
  • Injured mucosa. The presence of wounds, bleeding gums, ulcers and microcracks in the mouth are ideal conditions for the existence of the causative agent.
  • Household way. Tryponem feels comfortable in conditions of high humidity, therefore, using a mug or a fork, a toothbrush or other object after a patient, you also risk getting syphilis of the mouth.
  • Types of syphilitic rash

    Syphilis can affect any organs and systems, but the manifestations of syphilis depend on the clinical period, symptoms, duration of the disease, age of the patient and other variables. Therefore, the classification seems a bit confusing, but in reality it is very logical.

      1. Depending on the length of time that has passed since the moment of infection, early syphilis can be distinguished - up to 5 years, more than 5 years - late syphilis.
      2. According to typical symptoms, syphilis is divided into primary (solid chancre, scleradenitis and lymphadenitis), secondary (papular and pustular rash, spread of the disease to all internal organs, early neurosyphilis) and tertiary (gum, damage to internal organs, bone and joint systems, late neurosyphilis) .

    chancre - an ulcer that develops at the site of introduction of the causative agent of syphilis

    1. Primary syphilis, according to the results of blood tests, can be seronegative and seropositive. Secondary on the main symptoms are divided into stages of syphilis - fresh and hidden (recurrent), tertiary differentiate as active and hidden syphilis, when treponemes are in the form of cysts.
    2. The predominant lesion of systems and organs: neurosyphilis and visceral (organ) syphilis.
    3. Separately - fetal syphilis and congenital late syphilis.

    Most often, cutaneous syphilis is represented by papular syphilides, which differ in appearance. A rash occurs:

    • lenticular. It resembles a small knot with a flat top, color - red, diameter - 5 mm. If "fresh" syphilis is detected, a rash of this type appears on the forehead and bears the appropriate name - "Venus Crown",
    • miliary It is detected between the hair follicles, looks like nodules up to 2 mm in size. Nodules scaly, have a light pink color. Such a rash can be detected on the body in areas where there is hair. Sometimes itchy
    • coin-like. Detected at relapses. It resembles a seal of 2 cm in size, which has a blue-red or brown shade. After the disappearance of such a rash, scars remain. If the papule is located on the genitals, under the breast, and in other places where the person persists, the rash can transform into a weeping syphilide, which is highly contagious.

    In about 10% of cases, syphilis on the face and other parts of the body shows pustules - bubbles. Such rashes are characteristic of patients with reduced immunity.

    In appearance, the rash is similar to acne or dermatosis, a distinctive feature - a red rim. A crust forms over the bubbles, which will disappear after 2 weeks.

    Scars usually do not happen.

    Another type of skin manifestation is impetiginous syphilide, which is a papule that rots in the center. On the place of suppuration a layered crust is formed. There is another form of rash, when a couple dozen papules 1 cm in size appear, their peels dry out quickly. Such rashes persist on the skin for about 2 months.

    In the area of ​​the knees, an ecthyma can be found - it is an ulcer on the skin up to 2 cm in size, outlined with a purple rim and covered with a crust.

    As the size of ecthyma increases and the surface dries out, a crust in the form of a concave dome is formed - a syphilitic rupee. Such ulcers heal for a very long time, after them there is always a scar on the skin.

    Answering the question of what kind of rash in syphilis occurs most often, dermatovenerologists argue that in each case the symptoms are individual, often mixed, and it is impossible to precisely distinguish between manifestations.

    But we can say that rarely reveal herpetiform syphilide. This formation resembles a bubble for herpes.

    More often in this form is detected syphilis on the skin of alcoholics, patients with severe concomitant diseases.

    If secondary syphilis gives relapses, they are accompanied by leucoderma. It appears approximately in 6 months from infection and keeps for months, for years.

    Usually such a manifestation occurs on the neck, resembling a necklace. Rarely spots appear on the limbs, in the armpits.

    At first the spots are yellowish, then brighten. Itching and peeling is not observed.

    By the way, if you are interested in a doctor about how syphilis is manifested, you can find out that there is practically no itching or it doesn’t annoy too much.

    One of the unpleasant types of rash that cause discomfort, rashes on the head, which are complicated by baldness. The cause of alopecia - in the defeat of the hair follicles treponema.

    The inflammation around the bulb disrupts the process of nourishing the hair, as a result it gradually dies off and falls out. Foci of baldness are more common in the temples, on the crown, and on the back of the head.

    Plots without hair can be about 2 cm in size, and even the nearby bald spots cannot be combined. Hair loss with a syphilitic rash on the head is temporary, after a while the skin rash will begin to fade and hair growth will resume.

    However, during an active rash, the patient's head looks like a fur hat, eaten by moths.

    Symptoms of the secondary stage

    Symptoms of primary syphilis are a red spot of small size, turning into a tubercle after a few days. The center of the tubercle is characterized by gradual necrosis of the tissue (its death), which ultimately forms a painless ulcer, framed by hard edges, that is, a hard chancre.

    The duration of the primary period is about seven weeks, after the start of which after about a week all lymph nodes are enlarged.

    The completion of the primary period is characterized by the formation of a multitude of pale treponemas, causing treponemal sepsis. The latter is characterized by weakness, general malaise, pain in the joints, fever and, in fact, the formation of a characteristic rash, which indicates the onset of a secondary period.

    The secondary stage of syphilis is extremely diverse in its own symptoms and it is for this reason that in the 19th century French syphilidologists called it a “great monkey”, indicating, in this way, the similarity of the disease in this stage with other types of skin diseases.

    Signs of a general type of secondary stage of syphilis are the following features of lesions:

    • Lack of sensations of a subjective type (pain, itching),
    • Dark red color of rash,
    • Density,
    • Clarity and correctness of roundness or roundness of outlines without their propensity for possible merging,
    • Peeling of the surface is unexpressed (in most cases there is a lack of it),
    • Perhaps the spontaneous disappearance of formations without subsequent atrophy and the stage of scarring.

    Most often, the rash of the secondary stage of syphilis is characterized in the form of such manifestations (see photo of syphilitic rash):

    This stage of the disease is characterized by a small number of pale treponemas in the body, but it is sensitized to their effects (that is, allergic).

    This circumstance leads to the fact that even when exposed to a small amount of treponema, the body responds with a peculiar form of an anaphylactic reaction, which consists in the formation of tertiary syphilides (gum and hillocks).

    Their subsequent decay occurs in such a way that characteristic scars are left on the skin. The duration of this stage can be decades, which ends with a deep lesion received by the nervous system.

    Stopping on the rash of this stage, we note that the tubercles are smaller when compared with gums, moreover, both in their size and in the depth at which they occur.

    Lumpy syphilis is determined by probing the thickness of the skin, revealing a dense formation in it. It has a hemispherical surface, the diameter is about 0.3-1cm.

    Above the tubercle, the skin becomes a bluish-reddish color. Hillocks appear at different times, grouping into rings.

    Over time, necrotic decay forms in the center of the tubercle, which forms the ulcer, which, as we have already noted, leaves behind a small scar after healing. Given the uneven maturation of the tubercles, the skin is characterized by originality and diversity of the overall picture.

    Syphilide gummous is a painless tight knot, which is located in the middle of the deep skin layers. The diameter of such a node is up to 1.5 cm, while the skin above it becomes dark red.

    With the passage of time, the gum softens, after which it opens, giving off a sticky mass. An ulcer that has been formed in this way can exist for a very long time without the necessary treatment, but it will also increase in size.

    Most often, such a rash has a single character.

    Symptoms of secondary syphilis in the photo are more aggressive and pronounced. A rash affects large areas of the skin and can lead to inflammation in the lymph nodes.

    Many patients are interested in how syphilis looks in the mouth (photo below). As well as the usual, it goes through 3 stages and has characteristic visual manifestations.

    The first phase is characterized by the appearance of a specific hard chancre (painless ulcers), in the second phase they disappear and are replaced by roseola (rash on the mucous membrane), and in the third phase, gumma (knot) appears, changing the structure of soft tissues and even bones.

    Consider each of the stages in more detail.

    First phase

    On the photo chancre syphilitic

    At the first stage of infection, an ulcer of the correct form and very hard, like cartilage or cardboard, appears. If you look at photos of syphilis at different stages of the disease, then it has different rashes.

    In the first stage, only the area of ​​infection is affected. That is why the most effective treatment is considered at the initial stage of the disease.

    If a man has sexually infected during genital contact with a sick woman or during anal sex, signs of the disease appear on the head of the penis or at its base.

    In homosexuals who are addicted to oral sex, the mouth can become a place of infection. Very often, the first appearance of syphilis in these places appear in the corners of the mouth and resemble zadyed.

    However, unlike cracks caused by a vitamin deficiency, syphilitic ulcers do not cause scaling, are painless and have a very hard bottom.

    After a few days they pass and the disease moves to a new stage.

    As we have already found out, the main manifestations of primary syphilis are hard chancre, lymphangitis and lymphadenitis. How to distinguish them from other phenomena not related to syphilis? Let's look at these symptoms in more detail.

    Hard chancre - features

    In the photo, solid chancre looks like a normal ulcer: it is round or oval in shape, with a bluish-red tinge with an ulcer in the center. If the ulcer is not deep, it is called erosion. To touch the chancre is a solid formation, it feels like cartilage. The surface of the chancre is usually wet.

    The location of the chancre can be:

    • genital (labia, cervix, penis head, scrotum, etc.),
    • extragenital (oral cavity, lips, anus, fingers, chest, etc.).

    Symptoms of Tertiary Syphilis

    The previous stage can last up to 10 years, sometimes longer, depending on the state of the body, immunity, and many other factors. In modern conditions, secondary syphilis is well treated and fairly easy to diagnose, so the tertiary is extremely rare.

    At this stage, all organs and tissues are affected. Characteristic manifestation is gumma. This is a large rounded formation, dense to the touch. They can appear both under the skin and inside the body, shifting and deforming the internal organs.

    There may also be ulcers, bumps, granulomas and other types of formations.

    In contrast to the secondary stage, tertiary syphilis is slightly infectious. В этот период больной практически не выделяет возбудителей в окружающую среду, заразиться от контакта с гуммами или другими проявлениями почти невозможно.

    Сыпь при сифилисе – одновременно с самый характерный признак, и самый многообразный. How it looks depends on the individual characteristics of the course and condition of the body.

    Therefore, it is impossible to make a diagnosis on the basis of only external signs, a full diagnosis is required under the supervision of a venereologist.

    This is one of the most dangerous sexually transmitted diseases, which, fortunately, is quite rare and is rarely asymptomatic in men. Most often, it is sexually transmitted and only in rare cases can it be transmitted to the household.

    For example, if a person was sitting on the bench with the last stage of the disease or he used public transport. Therefore, experts do not recommend sitting on the beach on benches and sun beds, if they are not treated.

    Like AIDS, syphilis is transmitted through the blood of an infected person. For example, when drug addicts use one syringe for several people, as well as from a sick mother to a child through blood.

    Most often this happens during unprotected intercourse, through any natural discharge of the body. Even if the partner appears to be healthy outwardly, chancre can form on her internal genital organs, in contact with which the man picks up the infection.

    The incubation period lasts from 2-8 weeks, after which defects with a diameter of 2 mm to 2 cm form on the skin's surface. Such a formation is called hard chancre, it looks like a saucer-shaped ulcer with even edges and bottom. The ulcer hurts, settles down on the condensed site of skin.

    Another type of skin rash for syphilis - erosion, which have no clear boundaries. Chancres and erosion are often isolated, but they may well be several.

    Small-sized ulcers are found on the mucous membrane of women; large chancre choose such parts of the male body as the abdomen, inner thigh, and chin as the site of localization.

    Skin manifestations of syphilis are accompanied by an increase in nearby lymph nodes.

    To determine the development of this particular form of the infectious disease, you should familiarize yourself with the key signs of a rash in this condition:

    - correct and round shape,

    - do not peel in the center,

    - do not merge into single spots,

    - pain and itching do not accompany a rash in syphilis, itch itch, resulting from any other skin disease,

    - formations have clear edges and dense,

    - can disappear without medical treatment, leaving no scars,

    - able to appear on all parts of the body, including the visible mucous membranes.

    Considering the rash in syphilis of the secondary form, it is worth noting that all the formations pass without noticeable traces (spots, tubercles, vesicles). The only exceptions are erosion and ulcer.

    In the first case, after the formation disappears, a stain remains, and the appearance of ulcers is fraught with scars. Such trace marks make it possible to determine which primary element was originally on the skin.

    Such information helps to identify both the development and outcome of existing skin lesions.

    Symptoms of the primary stage

    The disease begins 3-4 months after the initial infection and lasts for several years. Clinical symptoms of the disease are:

    A rash of red or pink on the skin and mucous membranes as a symptom of secondary syphilis. Rash appears all over the body, not excluding the soles and palms. It may be accompanied by fever, headache and a feeling of aches throughout the body, as during the flu.

    Syphilitic baldness. There are diffuse alopecia, affecting a large area of ​​the scalp, and small focal.

    Spotted leucoderma (“necklace of Venus”) as a symptom of secondary syphilis. So called bleached spots on the skin behind and on the side of the neck, which appear in women at 4-6 months after the initial infection.

    Less commonly, these spots appear on the back, chest and abdomen, and even less often on the hands or near the armpits.

    A hoarse voice. It is manifested in the case of infection of the vocal cords.

    Symptoms of secondary syphilis in women

    The main features of the general type of secondary syphilis (especially the pathological elements):

    • dense structure
    • subjective sensations are not marked,
    • dark red tint of pathological elements
    • unexpressed peeling
    • clear contours
    • elements may spontaneously disappear.

    • benign course,
    • high infectiousness of secondary syphilides,
    • serological reaction in secondary syphilis is sharply positive,
    • if the treatment of secondary syphilis is timely, pathological syphilides quickly disappear.

    Symptoms of secondary syphilis

    The rash in secondary syphilis is of the following types:

    • roseolous syphilide. Symptoms of secondary syphilis of this stage occur most often in humans. The appearance of such pathological elements indicates that pale treponema began to spread throughout the body. On the skin spots of a pale pink shade are formed, not having sharp outlines. The shape of the elements is often rounded or oval. The maximum size is up to 1.5 cm. The spots do not rise above the surface of the epidermis, and also have no tendency to merge. Localized mainly on the neck and lateral surfaces of the body,
    • papular syphilis. This stage is characterized by the formation of elastic rounded nodules, also called papules. First, the elements are smooth and have a natural shine. But after a couple of days, the surface of the formations begins to peel slightly. There is no definite localization of papules, therefore they form on any part of the skin,
    • palmar and plantar syphilide. One of the most common varieties of papular syphilide. On the surface of the soles or palms are formed thickened nodules that resemble corns. Have a tendency to increase. As education increases, it can crack, which leads to the appearance of a specific border around the circumference. The similarity of such pathological structures with callosities is the reason that a person does not consult a doctor in a timely manner,
    • syphilitic leucoderma. Such a manifestation at this time is extremely rare, but still occurs. Pathological elements are formed on the neck, so this symptom is called the "necklace of Venus." Against the background of a brownish darkening of the skin, oval light foci form.

    Tertiary syphilis is a severe stage, which manifests itself after 3-5 years from infection. There are histories in medicine when syphilis on the face and body appears after 10, 20 and 30 years.

    Skin rashes in this case will be in the form of small spots or bumps and gum. The manifestation of symptoms through a long period of time is associated with the activation of pale treponema in the body.

    Such spots and acne with syphilis are not contagious, for the most part, they tend to spread to the periphery.

    Gum are nodules about 3 cm in size, which rise above the skin. The color gradually becomes purple.

    Usually reveal a single lesion in front of the leg. Over time, the gumma becomes softer, opens, forming an ulcer.

    For many months this gumma will remain on the skin, and after healing it will leave a “star-shaped scar” as memory.

    Lumpy syphilides are distinguished by a bluish-red tint; they are up to 1 cm in diameter. They can ulcerate, become covered with crusts, leave scars after healing.

    Secondary syphilis, signs and symptoms

    So, if you do not treat the disease, then a month or two after the first manifestations of syphilis - ulcers on the skin (hard chancre), the infection attacks the lymphatic and circulatory systems, which is reflected, first of all, on the skin and mucous membranes.

    Appear numerous rashes in the form of roseol, papules, pustules. Then comes the turn of the internal organs: a malfunction, an imbalance, a complete defeat.

    The main symptoms of the secondary period of the disease are:

    • syphilitic rash in the form of formations on the legs (condyloma) and point hemorrhages on the skin and mucous membranes,
    • syphilitic leucoderma (or Venus necklace), localized in the neck in the form of light spots on darkened skin. Leucoderma may also appear in areas of the chest, back, abdomen, waist, arms, axillae,
    • syphilitic alopecia (alopecia, hair loss),
    • syphilitic lesion of the nails (slowing down the development of the nail plate, the appearance of red spots on them,
    • syphilitic tonsillitis (inflammatory, difficult to treat processes in the oropharynx, numerous eruptions).

    The secondary period can last several years without visible deviations in health, from time to time there are only signs of respiratory diseases in the form of a slightly elevated temperature (37-37.5), rhinitis, painful sensations in the throat.

    Warts may disappear and reappear.

    In addition to the above symptoms can be observed:

    • nausea,
    • lack of healthy appetite
    • headaches,
    • fatigue and general weakness.

    Syphilitic leucoderma, species

    As already noted, syphilitic leucoderma (leukopathy, pigment syphilide) refers to the main symptoms of secondary syphilis, which appear in the absence of treatment for primary syphilis.

    What is dangerous leucoderma - the fact that its appearance means that the central nervous system is already affected. A necklace appears only a few months after infection. Also unexpectedly, the spots may disappear and reappear.

    Leucopathy in syphilis does not stand still - it develops and deepens, small whitish spots with clearly defined contours, tightly located to each other, but not merging, appear in different parts of the body, including on the palms, feet, genitals.

    Papules, roseola, pustules - all these types of rash, characteristic of the secondary period of syphilis.

    As the syphilitic leucoderma looks like, well demonstrate the photo on the Internet: the spots are round or oval in diameter up to one and a half centimeters. The spots are smooth, with no visible peeling and not disturbing their wearers.

    Whitish rash can be of different shades and sizes, so they were divided into types:

    • spotted (wide light spots, sharply distinguished on dark skin),
    • mesh (small, thin light specks look like a net or lace),
    • marble (the spots are almost invisible on the skin - there are no sharp contrasts of their color).

    When a leukopathic rash is detected, you should contact a venereologist, who, after conducting diagnostic tests and confirming the diagnosis, will offer compulsory inpatient treatment.

    This is due to the infectiousness of the disease and the strict regimen of therapy and the duration of the drug course.

    Treatment of syphilitic leucoderma

    With careful treatment and compliance with all recommendations of the doctor, leukopathy does not pass immediately, it will take a year or even two to cure it.

    Venereologist prescribes treatment:

    • penicillin antibacterial drugs every three hours for three to four weeks. The most commonly used are Erythromycin, Tetracycline, Ciprofloxacin, Azitrofitsin, Ofloxacin, Medicamycin,
    • immunomodulators and vitamins to increase the body's immune strength,
    • intramuscular administration of the natural antibiotic benzathine benzylpenicillin,
    • bismuth preparations with bactericidal action Vikalin, De-nol, Novobismol, Ulkavis, Vikair.

    In addition, the patient is recommended a special diet (diet).

    Drug treatment of the patient’s partner with syphilitic leucoderma is also mandatory.

    After the course of therapy, patients are registered, they are prescribed medical supervision: regular visits to the venereologist and regular tests.

    Only in the absence of relapses over the course of two long years, the patient can breathe deeply: he is removed from the register and considered to be recovered.

    Types of angina and their treatment

    At the word “angina”, the picture in the imagination is approximately the same: ulcers in the throat, which make the process of eating unbearably painful, high temperature, feverish state. In general, everything is correct. But this is the well-known follicular form. In fact, types of angina are an extensive list of almost a dozen titles. The disease manifests itself in different ways - depending on the pathogen that caused the disease, therefore, different measures are needed to control it.

    This is phlegmonous sore throat.

    Of all the types of the disease, phlegmonous tonsillitis is considered the most dangerous. She has a second name: "acute paratonson". The danger of it is that literally in a matter of hours, the patient may develop severe complications:

    Phlegmonous sore throat rarely occurs as an independent disease. More often it happens that another poorly treated form leads to it: staphylococcal tonsillitis, catarrhal. Chronic tonsillitis, when pathogens are constantly present in the throat, is also a risk factor.

    Phlegmonous sore throat often develops against the background of a seemingly subsiding inflammatory process. Pain in the throat has passed, the state of health has improved, and suddenly - the throat again becomes sharply painful, and so much so that the patient can neither swallow nor talk. It hurts him to open his mouth. Sore throat is often one-sided, because it causes a purulent process in one tonsil, which dramatically increases in size, swells. The pain can be given in the ear. Sharply "jumps" the temperature.

    Phlegmonous sore throat is rarely treated conservatively - unless at a very early stage, when an abscess is not yet formed. An abscess is opened more often, sometimes while the affected tonsil is removed. After that, the patient is prescribed a course of antibiotics, bed rest. After attaining 40 years of age, the risk of becoming ill with this form is reduced: phlegmonous sore throat most often occurs in young people, from 15 to about 40 years. This is due to the structural features of the tissues of the tonsils, which undergo certain changes with age.

    But there is a chance to catch, for example, staphylococcal sore throat or ulcerative-membranous sore throat. Staphylococcal tonsillitis is caused by a special bacterium that lives on the mucous membrane of the pharynx and oral cavity.

    With the weakening of immunity, against the background of chronic tonsillitis, prolonged stress, severe hypothermia, the patient's temperature rises (up to +39 0 С), a sharp pain in the throat is observed. Other symptoms include:

    Intoxication with staphylococcal quinsy is strong, it proceeds equally hard in both adults and children. Required bed rest. A doctor at any stage of a sore throat will prescribe antibiotics, gargling with “Hexoral” or other means, drinking plenty. You can not try to refuse antibiotic treatment, as angina gives serious complications:

    Ulcerative-membranous sore throat is in people whose immunity has been thoroughly undermined: those with chronic diseases, living too intense life, few rest, not paying attention to the "banal" ARVI. It is also called the “angina of Vincennes”. Typical symptoms:

    • severe sore throat,
    • bad breath,
    • the presence of a grayish film in the throat, which is easily removed with a medical spatula.

    Under the film, bleeding sores are formed. Often, ulcerative-filmy angina is accompanied by stomatitis, so that even drinking water gives a person great pain.

    The temperature in ulcerative-membranous sore throat is almost normal. Treatment of the disease takes up to 3 weeks. Complications are rare, but the disease itself causes a lot of trouble, deprives a person of working capacity for a long time. For some time, weakness persists.

    Syphilitic angina is always differentiated from other forms of the disease, since it is caused by sexually transmitted pathogens. Pale spirochetes are bacteria “responsible” for the occurrence of this form of angina.

    Syphilitic tonsillitis develops gradually. If you look at the photo, it becomes immediately clear that it differs from the other sore throats: a gray or gray-blue patina forms on the tonsils, which over time is replaced by so-called chancre - solid tubercles. In the latter stages of the disease, they are opened, transformed into ulcers and bleed. Chancre lasts for 3-4 months.

    Treat syphilitic sore throat only in the hospital. The carrier of this venereal disease is very dangerous for others, and for a long time. You can become infected with syphilitic angina through blood, kisses, and household means (using the same hygiene items). Syphilitic sore throat can appear even in a newborn whose mother has syphilis.

    Antibiotics such as amoxicillin, which will have to be taken for a long time, are saved from the disease. The sooner the treatment is started, the higher the chances for a speedy recovery.

    Among not too common forms of angina found candidal. A candidal sore throat is also infectious, since its spread causes a fungus that “nestles” on the tonsils due to the weakening of the body’s defenses. More often occurs in children and the elderly than in the working age.

    It is characterized by raid on the tonsils, swollen lymph nodes, temperature. Лечат этот недуг без применения антибактериальных средств, потому что они в данном случае неэффективны. Необходимы противогрибковые препараты. Кроме того, нужно полоскать горло, чтобы освобождать миндалины от омертвевших частичек бактерий и боровшихся с ними клеток.

    In the classification of angina allocate a special form - herpes. What disease is behind this word? From the name it is clear that the cause of the development of the disease is the herpes virus. It begins with pronounced flu-like symptoms:

    A little later there are bubbles in the throat, redness and sore throat. The disease is treated with antiherpetic drugs, complementing the treatment with drugs that strengthen the immune system. Looking for vitamins.

    Catarrhal sore throat - a form of the disease, which is considered the easiest. In this case, the patient has a sore throat, a small swelling of the tonsils, their redness. The temperature rises briefly. The general condition remains more or less normal. The illness passes in 3-4 days with the treatment of symptomatic means and the observance of bed rest. A layman can easily confuse him with pharyngitis.

    All these types of sore throats do not require the use of antibiotics. Moreover, with the first two antibacterial agents will only cause harm. But it is impossible to independently determine which form of angina struck the patient: the doctor must do this. Otherwise, treatment will be ineffective.

    The most common among all groups of the population are 2 forms: follicular and lacunar. They are difficult, but with proper therapy they pass quickly and without consequences.

    When the follicular form on the tonsils appear bloom and small pustules, causing severe pain. When lacunar ulcers lie deeper, plaque is more pronounced, purulent content flows, the patient’s general condition is severe, with signs of intoxication.

    In these forms, the doctor will prescribe antibiotics (from macrolides, cephalosporins, or other drugs), bed rest, frequent drinking, and gargling with furacilin. A good result gives the popular method of rinsing with warm iodine-salt solution.

    When the treatment is started on time 5-7, the disease usually subsides.

    If you feel a sore throat, you cannot immediately diagnose a sore throat and ingest antibiotics. It is necessary to consult a doctor, because, firstly, other illnesses can hide behind these unpleasant sensations: for example, acute pharyngitis, and secondly, even if it is a sore throat, the doctor should make a diagnosis based on the results of the examination and tests.

    When treating angina, one should not lose time: at best, the process can become chronic and will be called chronic tonsillitis, which can arrange “surprises” at the slightest decrease in immunity, and at worst - life-threatening complications can develop.

    Take care of yourself, increase immunity, and if you are sick - follow all the recommendations of the doctor. Health to you!

    • Symptoms and treatment of catarrhal angina
    • Symptoms and treatment of fungal tonsillitis
    • Is it possible to treat a sore throat without antibiotics?
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    Home "Diseases" Diseases of the throat "Tonsillitis.

    Tonsillitis. Angina. Treatment of tonsillitis. Types of tonsillitis: acute tonsillitis (tonsillitis) chronic tonsillitis. Our clinic specializes in the treatment of tonsillitis. Figures: 17 years of successful work 1891 people were cured 1324 prevented operations 756 came to us on the recommendation. Treatment of tonsillitis photo frames family tree photo and tonsillitis acute tonsillitis. Angina. Sore throat is a common infectious disease that pulls the manifestation of acute inflammation of the tonsils (they are the glands).

    Sore throat is a very contagious disease! It is possible to get infected by airborne droplets from a bacilli carrier or from a patient; an alimentary route of infection is often noted, that is, directly through direct contact, or food. But even more often, autoinfection (self-infection) occurs by microbes that live in the pharynx and normal, become more active as the body's immune system decreases. Frequent microbial pathogens of tonsillitis are streptococcus group a (b-hemolytic), and even less often staphylococcus, adenoviruses and pneumococcus. Almost all healthy people may have in-hemolytic streptococci as well, representing a danger to others, but at the same time they may not get sick themselves. After transferring angina, solid immunity does not appear, which can be said about many other infectious diseases. That is why a sore throat is a danger, arising again if the treatment of a sore throat has not been completed. Angina begins with a sharp rise in temperature up to 40, there is a sharp pain in the throat if you want to swallow something, there is weakness and headache, the body aches in the joints, sometimes pain in the heart. Due to the manifestation of the inflammatory process of the lymph nodes in the neck, head turns can be quite painful and limited.

    Angina is a possible complication of danger: parathonsillitis often flows into paratonsillar abscess, tonsillogenic sepsis or tonsillogenous mediastinitis, pharyngeal abscesses, cervical lymphadenitis, and acute otitis media. Complications begin as a result of insufficiently complete and incorrectly chosen treatment, or the treatment of angina independently. The first place in terms of the frequency of treatment belongs to the paratonsillar abscess - the process of suppuration of the parenchymal tissue in the palatine tonsil area, which resulted in the creation of a purulent sac that will have to be opened and the tonsil removed. In this case, the treatment of angina is to be a long, but effective process. Treatment of tonsillitis (sore throats). Treatment of tonsillitis should be both etiotropic and pathogenetic and symptomatic, subdivided into local and general effects. A general strengthening and hyposensitizing treatment of angina, as well as vitamin therapy, is underway. The process of treating sore throat is at home. The patient is isolated, set sparing mode.

    Lesions of the oral mucosa in syphilis.

    Photo of lesions of the oral mucosa in syphilis. In addition, syphilitic manifestations in the oral cavity, especially in the early ones. In continuous lesions (papular syphilitic angina). Papule. Lesion of the larynx, the main symptom of which is prolonged, almost.

    The disability of a patient with angina is on average from 10 to 14 days.

    In the event of a severe illness, the patient is hospitalized in the infectious disease ward. Chronic tonsillitis. Chronic tonsillitis is an infectious disease of a general nature, where the tonsils are the foci of infection, causing a chronic inflammatory process. It is possible to characterize chronic tonsillitis as a periodic exacerbation of tonsillitis, but it can also be a form of chronic tonsillitis without tonsillitis. The formation of inflammatory foci in the tonsils, as well as the development of the tonsillogenic process, subsequently takes place by the prolonged action of microorganisms on the lymphoid tissue of the tonsils. In the mouth of a person are ideal conditions for the origin and reproduction of microbes. Identical conditions are observed in the palatine tonsils, in which there are deep gaps - lacunae, in the region of which more than 30 all kinds of microbes accumulate, where the drainage is always disturbed. That is why chronic tonsillitis is caused by autoinfection, that is, by its infection, where immunity acts as a deterrent. In young children, viral infections prevail. Chronic tonsillitis is the same contagious disease as angina. A sick person has microflora that is too active, and therefore the parents of children can be the key to infection in children and even vice versa. Dow class pattern

    Chronic tonsillitis is often formed after previously transferred angina, due to which the inflammatory processes in a hidden way continue to turn into chronic processes. But there are cases when chronic tonsillitis appears without previous previous angina. The main complaints of patients are: weakness, fatigue, headache and lethargy, elevated body temperature. In many cases, the same symptoms can give a characteristic of angina. Accordingly, the treatment is prescribed similar. All this is due to allergization of the body and tonsillogenic intoxication. Local main complaints: discomfort when swallowing, unpleasant smell from the mouth, periodic sore throat, dryness, cough, frequent sore throats, painful and enlarged regional lymph nodes. In chronic tonsillitis, tonsillorenal syndrome (kidney damage) and tonsillitis syndrome (heart damage) can often occur. This is due to the fact that toxic and infectious factors that damage internal organs enter the body from the tonsils. For example, it can easily be streptococcal toxin, which violates the conduction of cardiac impulses and inhibits the respiration of muscle tissue of the heart, and this leads to myocardial malformation and dystrophy, or cause inflammation of the connective structures of the tissue, leading to rheumatism, affecting the thymus, which pulls immunodeficiency. It can also be liquid pus, which comes from the lacunae in the tonsils during swallowing movements of the muscles of the pharynx, poisoning not only the mucous membrane of the pharynx, but also goes into the gastrointestinal tract, where there is a violation up to dysbacteriosis.

    Treatment of chronic tonsillitis. Chronic tonsillitis can be divided into different forms, each with a different course of treatment. Palatine tonsils retain the body's immune resistance, inhibiting infection. Due to this, in the treatment of chronic tonsillitis, we strive to preserve this immune organ in case it does not become the entrance gate for infection. After the procedure for removing the tonsils, we solved the issue of frequent sore throats, henceforth they will not exist, but there is one thing but! With the solution of one problem, new ones will also appear - from the side of the broncho-pulmonary system and throat. We conduct a non-surgical (conservative) treatment method. As practice shows, to fully achieve the desired result, two or three courses lasting 10-15 sessions are enough for a certain period of time. To achieve this goal, we use a comprehensive method of treatment at the level of the organism as a whole, because the disease is also universal. Means that increase the body's natural reactivity in treating tonsillitis and tonsillitis: Hyposensitization therapy, sanitizing effects on the tonsils and regional lymph nodes, immunocorrection, means of reflex effects on the lymph nodes and palatine tonsils. Video reviews on the treatment of chronic tonsillitis in the ENT clinic. Marina, 21 years old, chronic tonsillitis.

    Syphilis (outdated: lues) is a chronic systemic venereal infectious. N. I. Pirogov in the article "syphilitic ulcers", published in 1837, wrote that. A50. 0 early congenital syphilis with symptoms, a50. 1 early. Antibiotics after the time of infection, for example, for tonsillitis,

    Chronic tonsillitis. How to treat? On the program "ladies' kaleidoscope" was discussed such a common disease as chronic tonsillitis. Most people who have experienced this disease do not even consider it necessary to consult a doctor and self-medicate. Alexander Puryasev, MD, head doctor of the ENT clinic, was invited as an expert and explained the reasons for the correct treatment of chronic tonsillitis. Interview about tonsillitis on the channel tdk. Chief Doctor of the “ENT-Asthma” Clinic, Doctor of Medicine a. S. Puryasev became a guest of the “our children” program on the TVC channel devoted to tonsillitis. The program touched upon the causes of the cause of tonsillitis in children of different ages, methods of recognizing the disease, types of angina, as well as methods of treatment, the use of antibiotics, including a beautiful large bouquet of flowers in chronic forms of the disease.

    See the recording of the program on our website. Sign up for a consultation on tonsillitis. User questions on our site about tonsillitis. I ask you to help as a specialist. I have chronic tonsillitis. Every year I experience tonsils on the tonsillor apparatus. Recently passed the course - how. The ENT told me that she burned her mucous membrane and earned subatrophy. Already a month I feel a burning sensation in the field of a trachea. An effective method of treating subatrophy and reducing burning sensation in the trachea. Answer doctor: hello. You will not earn any atrophy with tonsillor, especially in the area of ​​the trachea (they don’t put a tonzillor in there)))) check normally with a pulmonologist and a gastroenterologist.

    So I do not say that our doctor is the best. On the contrary, I want to understand the cause of chronic tonsillitis. And if I understood correctly, the reason is that the wrong treatment was prescribed / or was not treated. The doctor's answer: it is, they are not cured. Now actively engage in this, otherwise the tonsillitis will remain for life. Child 3.9: chronic tonsillitis, enlarged tonsils (1-3 st). Recently, nasal discharge often appears every time. Green. Basically, everything flows inward. From the local Laura has not heard anything intelligible yet. What can you do besides smear from the pharynx and nose?

    September 26, 2016. Angina symptoms in children The first symptom of angina in children can be considered a sore throat. As a rule, it appears gradually and.

    Earlier in the throat was pneumococcus. Answer doctor: I can not say.

    In order to make appointments, including on examination, you need to rely on a specific patient and see him. My husband has tonsillitis. How much need to remove the tonsils? Doctor's answer: if the disease is decompensated and there is a risk of complications, then the tonsils should be removed. If this is not the case, then you should first try conservatively, but seriously, effectively treated according to the scheme that we offer in our clinic. Cure chronic tonsillitis? Washing tonsilorom help weeks for two or three. Doctor's answer: we treat and cure well. But you need to go on the procedure for 10-15 days, repeated in six months to 5 days for 2 years. Ask your question about tonsillitis.

    Question: introduce yourself: email: update Please note that only the head doctor of the clinic answers to the questions asked a. A. S. Puryasev. You can get the answer to the question in accordance with the current workload. Hope for understanding.

    On the tonsils hard chancre unlike streptococcal sore throat almost. The difference from syphilitic angina from the banal is the absence.

    What is palmar and plantar syphilide. What is wide warts. What is syphilitic leucoderma. What is syphilitic angina.

    How can you catch syphilitic angina?

    Syphilitic leucoderma is an external symptomatic manifestation of secondary syphilis. It is caused by the process of damage to the central nervous system and is manifested in the form of spotted formations on the skin. Often these manifestations occur in women and are localized in the shoulders, abdomen, back, waist, chest and neck. Leucoderma is often confused with the usual pigmentation, which is congenital in nature or arises from a severe illness. But to determine the true source of stains can only be based on the results of analyzes.

    There are two types of syphilitic leucoderma - spotty and lace. The spotted subspecies implies the presence of light spots when the lace looks like hyperpigmentation and is caused by the presence of a large number of spots that are located at a short distance from each other and form a lace pattern. Moreover, the causative agent of syphilis in the analyzes of both forms manifests itself in different ways and requires different diagnostic techniques. The spotted appearance of leucoderma contains treponemas (bacteria that provoke the development of syphilis) in the upper layers of the affected skin, and the lace appearance has the nature of symptoms of the breakdown of the nervous system.

    Syphilitic leucoderma may exist for years, depending on the rate of the lesion of the body with syphilis. In addition, the presence of spots is directly related to pathological changes in the cerebrospinal fluid.

    The development of secondary syphilis in different patients is multifaceted and unpredictable. The disease may be accompanied by a malfunction of various organs and systems, and other diseases often arise on this basis, such as mucosal lesions, hepatitis, meningitis, bursitis, etc. Moreover, in the absence of treatment, the infection may manifest itself differently: rashes appear, then disappear, there may be abscesses or nodules. Over time, these formations are replaced by new symptoms, which are also destined to disappear, opening the doors to new appearances. With each subsequent manifestation of secondary syphilis, the number of affected areas decreases, but their size increases markedly.

    Основным проявлением сифилитической лейкодермы является наличие пятен на коже, которые, сливаясь, образуют собой узоры, иногда отчетливые, а иногда бледные. Также для проявления вторичного сифилиса характерны узелки в области половых органов и под мышками. They can gradually increase in size and grow together, becoming similar to cauliflower buds, while releasing fluid. These growths are usually painless, but they give off a foul odor, which can create great inconvenience in any movement.

    Often, when the organism is affected by secondary syphilis, patients with syphilitic tonsillitis occur. An increase in temperature and sore throat is not observed, but the tonsils redden noticeably, white spots appear on them. The mucous membrane of the throat and lips is covered with white stripes of various shapes, and red spots appear on the tongue, on which the nipples disappear. Since it is possible to get syphilitic sore throat if someone in your family has been diagnosed with this complication, you must avoid physical contact and strictly follow the rules of personal hygiene.

    Another noticeable symptom is the appearance of cracks in the corners of the mouth, and purulent crusts appear around the lips. Often on the forehead appear red-brown nodules, which are popularly called the "Venus crown". And the above-described areas with pigment formations on the neck and décolleté area were called “Venus necklace”.

    Alopecia in syphilis is one of the symptoms of the secondary course of the disease, which is manifested in partial loss of hair on the head. This process is often called syphilitic baldness, when part of the hair follicles fall out in whole areas, which looks like baldness. Also, these changes may affect eyebrows and eyelashes, which fall out foci. If syphilitic baldness is diagnosed in a timely manner, the correct treatment quickly regulates hair growth.

    For any manifestations of symptoms of syphilis, it is necessary as soon as possible to apply to the venereologic dispensary, where the doctor will carefully examine the patient, prescribe a series of tests and make a course of treatment. It will be inappropriate to try to get rid of the symptoms on your own, since the course of syphilis is directly related to the disruption of the central nervous system, from which there are signs of leucoderma and other manifestations. In addition, the disease provokes damage to the blood vessels and the meninges, which is why self-healing can be destructive.

    An important role in the collection of diagnostic data plays a complete history, collecting the history of various diseases of all the next of kin. Next, the patient is assigned a serological examination, which will help detect the infection.

    If a person who has become ill with syphilis is abusing drugs and alcohol, then the doctor can examine the entire body for ulcers, which can be covered with layered crusts. And even if the patient denies suffering from addiction, the doctor will easily determine the opposite.

    To all other visual examinations, it will be necessary to pass analyzes of scraping and smears from all mucous membranes, starting with the vagina, in the case of the female field. When false positive results are obtained, the study should be repeated according to the recommendations of the venereologist. But to double-check positive or negative results will be a waste of time.

    Treatment of leukoderma is reduced to taking medication prescribed by your doctor, the choice of which is based on the results of all tests. But since leucoderma is a symptom of secondary syphilis, for successful treatment an important step forward is to eliminate the root cause of the manifestations of the disease. For each patient, an individual set of medications is selected by specialists, which is mandatory if the prescribed norms of administration are observed. And each is personally assigned a special approach to treating syphilis.

    The main methods are:

    • preparations for internal and external use,
    • vitamin complexes,
    • in special cases, surgery and transplantation of donor skin.

    In drug treatment often resorted to:

    1. gluorsteroids.
    2. furocoumarin preparations.
    3. phenylalanine.
    4. tranquilizers.
    5. amino acid tyrosine.
    6. preparations containing zinc and copper.
    7. PUVA therapy.
    8. digestive enzymes.

    An integral part of a successful treatment is considered to be a specific diet, which is aimed at improving the functioning of internal processes, as well as containing all the trace elements that contribute to the proper functioning of drugs. Without compliance with the prescribed diet, the patient risks significantly reducing the effectiveness of the action of drugs, thereby postponing recovery for an unlimited period. In addition, most of the medications that are taken by mouth, according to the instructions require an initial meal at least half an hour. Therefore, to ignore these simple rules is not worth it.

    The basics of nutritional nutrition for people with syphilis, is reduced, above all, to the regularity of receptions, as well as to use only fresh and high-quality products:

    • fish and seafood dishes,
    • meat and liver dishes
    • dairy products,
    • cereals and legumes,
    • vegetables (especially beets, tomatoes, pumpkins, spinach, broccoli),
    • fresh greens
    • nuts and seeds,
    • bananas.

    Syphilis disease is of two types - acquired or congenital. Therefore, speaking of prevention, it would be more appropriate to describe how not to get infected with this infection, being a healthy person. If the disease is hereditary, for example, the child is infected through an infected mother who transmitted syphilis through the placenta, then preventive measures are reduced to stopping the infection throughout life. But for the rest there are typical standard rules that can protect against infection.

    1. For sexual intercourse, condoms are required.
    2. After intercourse, it is necessary to wash the genitals, mouth and nose.
    3. Use antibacterial wipes regularly.
    4. Use gauze bandages on the face when visiting public toilets.
    5. Adhere to proper nutrition and an active lifestyle to support immunity.
    6. As prescribed by the doctor to take preventive medications.
    7. Ventilate the room regularly and wash hands as often as possible after touching common objects, including travel in public transport.

    Also, an important step will be to acquire personal hygiene items (towels, washcloths, etc.) in order to avoid unwanted contamination not only of venereal diseases, but also other illnesses transmitted by household means.

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    Chancre felon should not be confused with typical chancre on the finger. Histologically, a typical hard ulcer is an infiltrative-erosive or infiltrative-ulcerative formation with characteristic changes in the vessels of the dermis. It has a number of histopathological signs: the absence of the epidermis (and parts of the dermis) in the central zone of the drug due to the formation of foci and areas of necrosis, in the dermis - a dense infiltrate of lymphocytes and plasma cells, peripherally, the infiltration has perivascular, derma changes in the form and proliferation and infiltration of all membranes (panvasculitis) with obliteration and thrombosis of some vessels, a lot of pale treponema in all areas (especially in the walls of blood vessels and in their circumference).

    Regional lymphadenitis (bubo concomitant, scleradenitis regional) is the second mandatory clinical symptom of primary syphilis.

    It is expressed in a kind of increase and compaction of the lymph nodes nearest to the chancre. In very rare cases, concomitant regional lymphadenitis may be mild or absent. With the localization of hard chancre on the genitals, inguinal lymph nodes undergo characteristic changes: they are enlarged to the size of beans, small plums, sometimes pigeon eggs, dense, not soldered to each other and with surrounding tissues, mobile, ovoid and completely painless during palpation spring up. The skin over them is not changed. It is characteristic that not one lymph node is enlarged, but a group (“pleiad”) of nodes, one of them being the largest, the other smaller. Scleradenitis can be both bilateral and unilateral. Syphilitic scleradenitis never suppurate or open. Sometimes patients with primary syphilis go to a doctor with a complaint only about enlarged lymph nodes, and they may not notice chancre due to localization inaccessible or inaccessible to external examination (endourethral, ​​anal chancre, small chancre on female genitals). Treatment with antibiotics in the incubation period of syphilis for any associated diseases may lead to the fact that regional lymphadenitis may occur before a hard chancre.

    Specific regional lymphangitis is a less permanent, but characteristic feature of primary syphilis. A lymphatic vessel is affected throughout from a hard chancre to nearby lymph nodes. It is felt in the form of a densely elastic, painless cord, which sometimes has thickening, best of all, the tension of regional lymphangitis is felt on the back of the penis, at its root. The accession of a secondary infection (staphylococcus, streptococcus, as well as fusospirillosis symbiosis), leading to the development of acute inflammatory phenomena, obscures the classic signs of hard chancre. Hyperemia and edema appear in the circumference of syphiloma. Its bottom is covered with mucopurulent discharge. With the localization of hard chancre on the genitals, the complication of its secondary infection leads to the occurrence of vulvitis and vulvovaginitis in women, and in men - balanoposthitis, which is usually complicated by phimosis or paraphimosis. Regional lymph nodes in these cases often become painful, sometimes welded and slow-moving, the skin above them can redden and swell. In the case of noted complications, it is necessary to prescribe a patient local indifferent therapy (preferably lotions from an isotonic sodium chloride solution), and oral administration of sulfonamides is acceptable. Until the diagnosis is clarified, antibiotics cannot be prescribed, which can cause a rapid regression of both syphilitic and banal lesions and thus impede the final diagnosis. Persons weakened (usually in chronic alcoholics) may experience more severe complications of hard chancre - gangrenization and phagedenization. When gangrene solid chancre undergoes necrotic decay with the formation of a dirty gray or black scab, after rejection of which formed deep ulcers. Phagedenization is characterized by repeated outbreaks of gangrenization and the spread of the ulcers in breadth and depth from the primary syphiloma, accompanied by bleeding. From about the third to fourth week of the existence of a hard chancre, all the lymph nodes begin to grow dense, and specific polyadenitis, an important concomitant symptom of the end of the primary and the onset of secondary syphilis, begins to grow dense. Specific polyadenitis has diagnostic value only in a complex of other symptoms of syphilis. As a result of generalization of syphilitic infection at the end of the primary period, there are headaches, pain in bones and joints (especially at night), insomnia, irritability, general weakness, fever (sometimes up to 39-40 ° C). In the blood - mild hypochromic anemia, leukocytosis, increased ESR (up to 30-60 mm / h).

    Secondary syphilis is characterized by the generalization of syphilitic infection, reaching its highest development.

    In addition to the skin, mucous membranes and lymph nodes, the internal organs, central nervous system, bones, joints, blood-forming organs, organs of hearing, sight, etc. may be involved in the pathological process.

    The main manifestation of syphilitic infection in the secondary period aregeneralized skin rashesand mucous membranes (secondary syphilides).

    Rashes of each of the attacks of the secondary period, having existed for about 1.5-2 months, undergo a spontaneous regression in order to appear again after a more or less long latent period. The first rash, which marks the beginning of the secondary period, is distinguished by a special brightness and an abundance of rash; it is called secondary fresh syphilis. He is usually accompanied by a fading hard chancre. All subsequent attacks of the secondary period are called secondary recurrent syphilis. The intervals between bouts of secondary syphilis, when the rash on the skin and mucous membranes are absent, are called secondary latent syphilis. Various rashes of the secondary period during the first half of the year are accompanied by specific polyadenitis. Secondary syphilides have a number of common features that distinguish them from other skin rashes: they are ubiquitous, have a benign course, febrile symptoms are absent, there is also no acute inflammatory phenomena and subjective sensations, resistance to local treatment, rapid disappearance under the influence of anti-syphilitic treatment is observed. Important in practical terms is the question of the distinction between secondary fresh and secondary recurrent syphilis, since the duration of infection and, accordingly, the amount of treatment in these cases differ. Despite the identity of the individual manifestations of fresh and recurrent syphilis, there are several clear signs that distinguish secondary fresh syphilis from secondary recurrent.

    There are 5 groups of changes in the skin, its appendages and mucous membranes in the secondary period of syphilis: spotted syphilides, papular syphilides, pustular syphilides, syphilitic baldness, syphilitic leucoderma.

    A representative of the group of spotted syphilides is syphilitic roseola, which is also the most common syphilide of the secondary (especially secondary fresh) period. Roseola is observed in 75-80% of patients with secondary syphilis. A typical syphilitic roseola, which usually appears at the beginning of the secondary period of syphilis, is a pink spot the size of a lentil to the nail of the little finger, an incorrectly rounded shape, not flaky, disappearing under pressure. Roseolour spots are abundant, located randomly, most often on the body (especially on its lateral surfaces) and on the extremities. Rashes appear gradually and usually reach their full development within 8-10 days.

    The following types of syphilitic roseola are distinguished: edematous (urtikarnaya), drain, recurrent (large in size) and ring-shaped (in the form of rings, arcs).

    The equivalent of roseola on mucous membranes is erythematous syphilitic tonsillitis: Drain erythematous patches of dark red color with a bluish tinge in the throat area, sharply delimited from the surrounding healthy mucous membrane. Syphilitic erythematous tonsillitis usually does not cause subjective sensations (or they are insignificant), is not accompanied by fever and other common phenomena.

    Papular syphilis in the secondary period of syphilis is as common as syphilis roseola. Thus, syphilitic papules and syphilitic roseola are the main manifestations of secondary syphilis. Papular syphilide is more commonly seen in secondary recurrent syphilis. The syphilitic papule is a compact, devoidal formation, sharply delimited from the surrounding healthy skin and protruding above its level. Depending on the duration of the infection, the characteristics of the patient’s skin and the localization of papular syphilide, it may have a different appearance.

    There are nine main varieties of papular syphilide.

    Lenticular (lenticular) syphilide more often observed in secondary fresh syphilis, is represented by clearly delimited flat, rounded papules the size of lentils, bluish-red in color, with a densely elastic texture, with a smooth shiny surface. Gradually, the papules acquire a yellowish-brown shade, flatten, on the surface of them appears scarce peeling of the collar.

    Miliary - differs in the small sizes (with poppy grain) and a semi-conic form of papules.

    Nummular (coin-like) - characterized by a significant size of papules (with a large coin and more), a tendency to group.

    Ring-shaped - different ring-shaped arrangement of papules.

    Seborrheic: papules are localized on the face, head, along the edge of the forehead, and are distinguished by oily scales on the surface.

    Erosive (weeping): papules are distinguished by a whitish macerated, eroded or weeping surface, which is due to localization on the mucous membrane and in the folds of the skin, is among the most infectious manifestations of syphilis.

    Broad Condylomas (Vegetative Papules) located in areas of friction, physiological irritation (genitals, anus). Differ in large size, vegetation (sprawl up) and eroded surface.

    Horny papules (syphilitic calluses) characterized by the powerful development of the stratum corneum on the surface, very similar to corns.

    Psoriasiform papules characterized by pronounced peeling on the surface. Папулезные высыпания нередко появляются и на слизистых оболочках, особенно рта. Клинически они соответствуют эрозивным (мокнущим) папулам. В полости рта эрозивный папулезный сифилид чаще всего занимает область мягкого неба и миндалин (сифилитическая папулезная ангина).Papular rash on the mucous membrane of the larynx leads to hoarseness.

    Pustular syphilides are a rare manifestation of secondary syphilis. They are usually observed in debilitated patients with a severe (malignant) course of the process.

    There are five varieties of pustular syphilide.

    Acne - small conical pustules on a dense papular base, quickly shrink into crusts, slowly dissolve.

    Impetiginous - superficial pustules formed in the center of the papules and rapidly shrinking into the crust.

    Osenoid - differs in spherical pustules the size of a pea, whose center quickly dries into a crust, are located on a dense base.

    Syphilitic ecthyma - Late syphilide (six months and later from the onset of the disease): a deep rounded pustule the size of a large coin dries quickly into a thick crust incrusted into the skin, upon rejection of which an ulcer with sharply cut edges and a peripheral roller of a specific infiltration of a bluish-blue color develops. Ecthymes are usually rare, leaving a scar.

    Syphilitic Rupee - an ectopic-like element under a layered conical (oyster) crust due to the growth and repeated disintegration of a specific infiltrate. Usually single, heal by scar. Pustular and ulcerative syphilides can rarely be located on the mucous membranes. When localized to the tonsils and soft palate, the process has the appearance of pustular-ulcerative tonsillitis. Acne-like, impetiginous, and open-backed syphilides are usually observed with secondary fresh syphilis, while deep varieties (ecthyma and rupee) are symptoms of recurrent syphilide.

    Syphilitic baldness is usually observed in the second half of the disease, i.e., in secondary recurrent syphilis. Two clinical varieties are known - diffuse and small focal. Sometimes they are combined in the same patient, presenting a mixed form. Diffuse syphilitic baldness does not have any characteristic features. Any part of the skin can undergo baldness, but the scalp of the head is affected more often. An acute onset and a rapid course of the process attract attention, sometimes on the head or pubis the amount of remaining hair is calculated in units. Small focal syphilitic baldness is expressed by multiple small foci of alopecia of irregularly rounded contours, randomly scattered over the head (especially in the temples and the back of the head), a symptom of "fur eaten by moth." It is extremely characteristic that the hair in the lesions does not fall out completely, and in part - a sharp thinning of the hair occurs. The skin in the foci of alopecia is not changed, the follicular apparatus is fully preserved. Sometimes small focal baldness affects the eyebrows and eyelashes, which are of unequal length - “step-like” eyelashes, a symptom of Pinkus. Syphilitic alopecia exists for several months, after which the hair is completely restored. Hair loss in syphilitic alopecia is due to the development of specific infiltration in the hair follicle without any previous clinical manifestations of syphilis at the sites of injury. In the area of ​​pleshlenok proved the presence of pale treponema.

    Syphilitic leucoderma (syphilide pigment) pathognomonic for secondary (usually recurrent) syphilis, more common in women. Its predominant localization is the lateral and posterior surface of the neck. ("The necklace of Venus"). Often, the chest, shoulder girdle, back, abdomen, waist, and sometimes limbs may be affected. In the affected areas, a gradually increasing diffuse hyperpigmentation first appears. Subsequently, hypopigmented round spots the size of a fingernail appear on its background. There are spotted and lace syphilitic leucodermawhen it is a lot of spots and they almost merge with each other, leaving only small strips from a hyperpigmented background. It exists for a long time (sometimes for many months and even years), its development is associated with damage to the nervous system (pale treponemes are absent in the affected tissue).

    In the presence of leucoderma, patients usually experience pathological changes in the cerebrospinal fluid.

    Polyadenitis considered one of the most important symptoms of secondary syphilis. It is characterized by multiple lesions of the lymph nodes, it always develops in many groups of lymph nodes, and it affects both the subcutaneous, accessible by direct palpation, so deep, up to the mediastinal and retroperitoneal, that is revealed by special research methods.

    In the secondary period, practically all organs and systems may become involved in a specific process, although this is observed, although not very often. Of primary importance is the defeat of bones and joints, the central nervous system and some internal organs. The lesion of the bones occurs in 5% of patients in the form of diffuse periostitis, manifesting painful testovatnymi swelling, night pain in the bones. Less common are osteoperiosteis. The bones of a skull and tibial are most often affected. The lesion of the joints usually proceeds according to the type of polyarthritic synovitis with the formation of effusion in the articular cavity (hydrarthrosis): the joint appears swollen, enlarged, painful with pressure. The appearance of pain when trying to move and the disappearance of pain in the joint during movement is very characteristic. The most important specific secondary period viscerata include syphilitic hepatitis (liver enlargement and tenderness, fever, jaundice), gastritis, nephrosis nephritis, myocarditis. Syphilitic viscerites quickly pass after specific treatment. The defeat of the nervous system in the secondary period of syphilis is usually called early neurosyphilis. The lesion of the mesenchyme, ie, the meninges and the vessels, is characteristic. Neurological examination and analysis of cerebrospinal fluid show syphilitic meningitis (often asymptomatic), sometimes complicated by hydrocephalus, and also syphilis of cerebral vessels (meningovascular syphilis), rarely syphilitic neuritis and polyneuritis, neuralgia. The percentage of positive classical seroreactions in the secondary period of syphilis is extremely high - a positive Wasserman reaction in secondary fresh syphilis is observed in 100% of cases, in secondary recurrent - in 98-100%.

    Tertiary syphilis develops in about 40% of patients in the 3-4th year of the disease and lasts indefinitely.

    Inadequate treatment or its absence in the preceding stages of syphilis, severe comorbidities, poor living conditions, etc. contribute to the transfer of the disease to the tertiary period. The manifestations of the tertiary period are accompanied by the most pronounced, often indelible disfigurement of the patient’s appearance, severe disorders in various organs and systems, lead to disability, and often death. Distinctive features Tertiary are the occurrence of powerful inflammatory infiltrates in the form of hillocks and gummas prone to disintegration with subsequent extensive destructive changes in the affected organs and tissues, productive nature of inflammation with formation of infectious granuloma, limited lesions (unit cells), the ubiquity of lesions, undulating, intermittent flow. This shows a similarity with the secondary period (manifestations of tertiary syphilis, usually lasting several months, undergo spontaneous regression, followed by a period of relative rest of the infection). In the presence of clinical manifestations, tertiary active syphilis is diagnosed, in the absence thereof, tertiary latent syphilis. Recurrences of tertiary lesions are observed infrequently and are separated from each other by long (sometimes perennial) hidden periods, the duration of tertiary syphilides is calculated not weeks, but months and years, so the attacks of tertiarism are very long, in the tertiary syphilides an extremely insignificant number of treponema is found, In this connection, no studies are conducted on the presence of the causative agent, and they are characterized by a low infectiousness of these manifestations, a tendency to develop specific lesions in the places of non-specific major irritations (primarily in the field of mechanical injuries), classical serological reactions in 1/3 of patients with tertiary syphilis are negative, which does not exclude his diagnosis, the intensity of specific immunity in the tertiary period gradually decreases (this is due to a decrease in the number of pale treponema in the patient's body), In this connection, true resuperinfection with the development of hard chancre on the site of a new introduction of pale treponema becomes possible. The transition of a syphilitic infection to the tertiary period is explained by further changes in the immunobiological reactivity of the organism towards an increase in the state of infectious allergy, so that the manifestations of tertiary syphilis are infectious and allergic in nature. Most often skin, mucous membranes and bone skeleton are involved in the gummous process.

    Skin lesions are represented by two syphilides - bumproth and gummy.

    The main element of tubercular syphilide is a small dense tubercle, lying in the thickness of the skin, hemispherical in shape, the size of a cherry seed, dark red or bluish-red. Its surface is smooth and shiny. After a few weeks or months, the tubercle softens and ulcerates, forming a rounded, rather deep ulcer with valiform, sharply cut edges. Gradually, the bottom of the ulcer is cleared of decay, covered with granulations and turns into an atrophic pigment along the periphery of the scar, on which new rashes never occur. Group of scars has a mosaic look.

    Gumma is a ball the size of a walnut, of a densely elastic consistency, with sharp borders, covered with a purple-red skin, restrictedly mobile.

    Subjective feelings are minor or absent. Subsequently, the softening and disintegration of the gum is noted with the formation of a deep ulcer, the bottom of which is covered with the remnants of a decaying infiltrate (“gummy core”). The ulcer has a rounded shape, a deep bottom and very characteristic roll-shaped thick, densely elastic, bluish-red edges. Gradually, the ulcer cicatrizes, leaving a discolored scar with a hyperpigmentation zone around the periphery. Sometimes there is an irradiation of gum - the spread of gummous infiltration to neighboring tissues (from the skin to the periosteum, bone, blood vessels), which can not only aggravate the disfigurement of the patient's appearance, but also lead to death. Gum mucous membranes are quite common. First of all, the mucous membrane of the nasal cavity is affected, then the pharynx. Gummy lesions of the tongue, hard and soft palate, nose, pharynx, larynx lead to severe and often unavoidable disorders of speech, swallowing, breathing, change the appearance of the patient ("saddle" nose, complete destruction of the nose, perforation of the hard palate). Among the gummous lesions of other organs, tertiary syphilides of the periosteum, bones and joints are more common. The bones of the legs, forearms, skulls, knee, elbow and ankle joints are more often affected. Changes to other organs and systems are described in special manuals.

    Congenital syphilis is transmitted to the offspring of a sick mother during pregnancy through a placenta affected by syphilis.

    The social significance of congenital syphilis is aggravated by the high mortality of children with congenital syphilis: the percentage of mortality is higher, the lower the child’s age.

    Syphilis can be transmitted through the placenta in two ways.: 1) more often pale treponemas are introduced into the body of a child as emboli through the umbilical vein, 2) less often pale treponems penetrate into the lymphatic system of the fetus through the lymphatic slits of the umbilical cord. A healthy placenta is the perfect filter for pale treponemas. In order for the causative agent of syphilis to enter the fetus, a preliminary syphilis lesion of the placenta with a subsequent violation of the placental barrier is necessary. The transmission of syphilis to offspring occurs mainly in the first 3 years after infection of the mother, in the future this ability gradually weakens, but does not fade away completely (“Kassovich’s law”). The effect of syphilis on pregnancy is expressed in the violation of its course in the form of late miscarriages and premature births, and often there are stillbirths (premature or in time), the birth of sick children. Depending on the period of syphilitic infection in a child, the following periods of congenital syphilis are distinguished: fetal syphilis, early congenital syphilis (it distinguishes syphilis of infancy and syphilis of early childhood) and late congenital syphilis (after 4 years). The division of congenital syphilis into early and late is due to clinical manifestations, and early congenital syphilis basically corresponds to secondary, and late to tertiary acquired syphilis.

    Defeat of the fetus syphilis occurs on the 5th month of pregnancy and is accompanied by changes in the internal organs, and somewhat later, and the skeletal system. The primary and primary damage to the liver in such fetuses is confirmation of the placental theory of the transmission of syphilis to offspring. Specific lesions of the internal organs of the fetus are mostly diffuse inflammatory in nature and are manifested by small cell infiltration and proliferation of connective tissue. Common and severe lesions of the visceral organs of the fetus often make it unviable, leading to late miscarriages and stillbirths. There is no organ and system that could not be affected by syphilis in infancy. The most frequently observed lesions of the skin, mucous membranes and bones.

    Early manifestation of syphilis in children infancy is syphilitic pemphigus. The rash is localized on the palms, soles, forearms and legs. Bubbles the size of a pea and a cherry, initially serous, then purulent, sometimes hemorrhagic, are located on an infiltrated base and are surrounded by a specific bluish-red papular infiltrate zone. Diffuse infiltration of Gochsinger usually localized on the soles, palms, face and scalp. The lesion is sharply delimited, has at first a smooth, shiny, bluish-red, then cracked brownish-red surface, has a dense-elastic consistency, which leads to the formation of cracks that have radial directions in the circumference of the mouth and leave the so-called Robinson-Fournier radiant scars for life . Also observed common or limited roseolous, papular and pustular rashes in all their varieties, similar to those in the secondary period of syphilis. A feature of roseola in infants is its tendency to merge and flaking. Papular rashes have a tendency to erosive and subsequent pustulization. Skin rashes are often preceded by fever. Hair loss may have the character of both diffuse and small focal syphilitic alopecia. The defeat of the mucous membranes often occurs in the form of syphilitic rhinitis, which is a specific erosive-papular hyperplastic anterior rhinitis. There is a narrowing of the nasal passages, mucopurulent discharge, shrinking in the crust. Breathing through the nose is severely hampered, which makes the act of sucking impossible. As a result of ulceration of the papular infiltrate of the nasal septum, its destruction with the deformity of the nose (in the form of a saddle or blunt, "goat") is possible. On the mucous membrane of the mouth and throat may be observed syphilitic papules, prone to ulceration. Very pathognomonic lesions of the skeletal system in the form of osteochondritis, sometimes ending with pathological fractures of the bones of the extremities (Parro's pseudo-paralysis). In children older than 4 months, manifestations on the skin and mucous membranes are more often limited, bones are dominated by the effects of periostitis, lesions of the internal organs and the nervous system are less common. In case of congenital syphilis of early childhood, limited large-bulky (usually moist) rashes such as wide condylomas are more often observed on the skin, erosive papules on mucous membranes, and often bones (syphilitic periostitis of long tubular bones) are often affected.

    Manifestations of late congenital syphilis arise between the ages of 5 and 17 years and correspond to the defeat of various organs and systems in acquired tertiary syphilis. In addition, there are persistent persistent signs that are the result of syphilis, transferred during infancy, or appearing later due to the influence of a syphilitic infection on the developing bone system and some other organs. Именно совокупность этих признаков позволяет отличить поздний врожденный сифилис от третичного.

    Признаки позднего врожденного сифилиса делятся в зависимости от степени специфичности на абсолютные, или безусловные, относительные, или вероятные (наблюдаются чаще при позднем врожденном сифилисе, но встречаются и при других болезнях), и dystrophy (may be the result of both congenital syphilis and other diseases).

    Unconditional relates getchinson triad: Getchinson teeth (barrel-shaped or chisel-shaped incisors, chewing surface opa, ata, otellumus aortic cavity), parenchymal keratitis (uniform milky-white cornea opacities with photophobia, lacrimation and blepharospasm), labyrinth, fever with photophobia, lacrimation and blepharospasm, labyrinth, fever with photophobia, lacrimation and blepharospasm, labyrinth opaque, with photophobia, lacrimation and blepharospasm, labyrinth opaque, with photophobia, lacrimation and blepharospasm, labyrinth ophthalmology with photophobia, lacrimation and blepharospasm, labyrinth ophthalmology with photophobia, lacrimation and blepharospasm, labyrinth opaque, with photophobia, lacrimation and blepharospasm, labyrinth opaque with photophobia, lacrimation and blepharospasm, labyrinth optic with dystrophic processes in the auditory nerve).

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