What skin rashes are characteristic of syphilis. Features of skin manifestations of syphilis in men and women

Skin manifestations of syphilis vary significantly depending on the stage of sexually transmitted pathology. Features of the clinical picture allow the doctor to quickly diagnose the disease and begin drawing up a therapeutic regimen. Often the symptoms of syphilis are similar to signs of autoimmune, allergic or infectious skin lesions. In this case, laboratory diagnostics are performed to differentiate from atopic dermatitis, herpes zoster, rubella or measles. Syphilitic manifestations affect not only skin, but also the mucous membranes of the genital organs and respiratory tract.

The first signs of the disease

The causative agents of skin syphilis enter the human body through the skin and mucous membranes, the integrity of which has been compromised by various reasons. From this moment, the incubation period begins, during which pale treponema begins to actively grow and reproduce. The object of their localization becomes The lymph nodes and vessels. If laboratory tests of biological samples are carried out at this stage, their results will not show the presence of gram-negative spirochetes. Depending on a person’s health status and existing chronic diseases, the duration of the incubation period varies from a week to a month. In some cases, the first severe symptoms develop only six months later.

If during the incubation period the patient takes antibacterial agents to treat another pathology (for example, a respiratory or intestinal infection), then the initial clinical manifestation of syphilis will occur much later due to the death of part of the pale treponema. The time of bacterial carriage will be significantly reduced when infected from two or more sources. The first and one of the most pronounced signs of the end of the incubation period is chancre, or syphiloma. It is always accompanied by enlarged regional lymph nodes, and then the entire lymphatic system of the body is gradually involved in the pathological process. Besides skin manifestations the infected person towards the end initial stage venereal disease the following symptoms occur:

• hyperthermia;
• headaches and muscle-joint pain;
• weakness, fatigue.

The reason for the appearance of the first signs of general intoxication of the body is the release of infectious agents, as well as toxic products of their vital activity, into the systemic bloodstream.

“Warning: Timely diagnosis of sexually transmitted pathology is hampered by a person’s lack of basic knowledge about the symptoms of syphilis. The infected take it for a microtrauma and begin to treat it with local antiseptics, while gram-negative spirochetes actively multiply in the body.”

At the base of this syphilitic ulcer there is an accumulation of cellular elements mixed with blood and lymph. Sometimes, in the absence of qualified medical care, the chancre spreads into the deeper layers of the epidermis and acquires the structure of cartilaginous tissue. But in most cases, after a couple of months, scarring of hard ulcers occurs, and when they are localized on the mucous membranes of the genital organs, epithelization occurs. Infected people mistake this symptom of syphilis for a complete recovery and do not go to a hospital. Treatment started at the stage of chancre formation helps to avoid the development of irreversible complications. Where does syphiloma most often form:

• the ulcer affects the penis, scrotum, and pubic area in men;

• In women, chancre can be localized on the labia majora and minora, clitoris, cervix, and vagina.

This primary symptom syphilis is detected around anus, but this location of a hard ulcer is more typical for men. Extragenital chancre develops on the fingers, eyelids, tongue, tonsils, lips, skin on the face and abdomen.

Syphiloma is visualized as a small (0.1 inch in diameter) smooth spot, the edges of which may be slightly raised above the skin or mucous membranes. The color of the chancre may vary slightly, but generally the color of the ulcer is dominated by red and blue shades. When pressing on syphilitic lesions painful sensations absent or slightly expressed.

Venereologists often diagnose patients with chancres that differ significantly in appearance from a classic ulcer. Before starting treatment, such patients undergo differential laboratory and, if necessary, instrumental studies.

• Indurative ulcer. This type of chancre is characterized by the formation of severe swelling that spreads beyond the skin lesion. The color of the seal varies greatly. The resulting syphilomas can be bluish-red or pink in color. Swelling most often affects the labia in women and the foreskin in men. Indurative ulcers do not disappear within 2-3 months, and if left untreated, they provoke numerous complications.
• Felon. Syphilitic clinical manifestation occurs on the nail bed and refers to bone pathologies. A severe inflammatory process develops at the site of the lesion, resulting in the formation of an open wound, often with purulent contents. The finger swells and changes color to bluish-red. The pain is so severe that it is only temporarily relieved by non-steroidal anti-inflammatory drugs. With extensive suppuration, the nail is rejected. Treatment often involves a series of surgical procedures.
• Amygdalate. This type of hard ulcer affects the tonsils, located in the upper respiratory tract. This symptom of syphilis is very similar to the main one clinical manifestation follicular or lacunar tonsillitis. The tonsil becomes dark blue, swells, provokes severe pain when swallowing. Amygdalate is accompanied by symptoms of general intoxication, therefore, to differentiate it from respiratory infections A number of laboratory serological tests are carried out.
• Mixed syphiloma. Treatment of a sexually transmitted disease is sometimes complicated by periods of mixed symptoms. Most often, this sign of a sexually transmitted disease occurs during simultaneous infection from two bacteria carriers. Initially, a small soft ulcer forms, gradually becoming denser over time. The result pathological process the formation of a large chancre occurs. If a hard mixed ulcer forms on the lip, then the red border on the lower or upper edge becomes its localization. Most often, the contents of the chancre are covered by a thick film, and sometimes by a thick grayish coating. As Treponema pallidum grows and actively reproduces in syphiloma, the ulcer spreads to healthy tissue, forming deep cracks similar to “jams.”

Secondary symptoms of pathology

Clinical manifestations of skin syphilis at the second stage of venereal pathology occur immediately after the penetration of gram-negative spirochetes into the bloodstream. The bloodstream carries infectious pathogens to the internal organs, causing a decrease in their functional activity. The infected person's body temperature rises, joint and muscle pain, psycho-emotional disorders develop. But the most pronounced symptom in the clinical picture is skin rashes different localization, shape and color of spots.

The duration of the secondary course is several years, during which gradual damage occurs to soft, cartilaginous, articular, muscle and bone tissues. Destructive-degenerative changes occur against the background of skin rashes as a result of intoxication of the body by pathogenic bacteria and toxic products of their vital activity. Biological barriers can no longer do their job of purifying the blood, which is why a syphilitic rash appears on the skin.

“This is interesting: At this stage of venereal pathology, the patient is most contagious. Chancres contain high concentration Treponema pallidum."

Secondary syphilis develops in an infected person 2-3 months after infectious pathogens enter the body. Despite multiple rashes on the upper layer of the epidermis, skin itching is completely absent. When pressing on pimples and spots, a person does not experience painful or other discomfort. If treatment is not carried out, then for 1-2 years the following qualitative and quantitative characteristics of the rash remain:

• characteristic coloring;
• disappearance without atrophic formations, including scars;
• clear boundaries;
• lack of spread to healthy areas of the dermis;
• sudden formation.

At the initial stage of the second stage of the disease, skin manifestations are significantly pronounced and can affect most of the human body. In the absence of treatment, syphilis (outdated name - lues) develops into its severe chronic form, which is characterized by frequent remissions followed by painful relapses. After an exacerbation, secondary hard chancre may disappear altogether or become paler, merging with the color of the skin. As the pathology progresses during relapses, the severity and number of rashes decreases. At the end of this period, 2-3 large ulcers often form on the skin.

Syphilitic roseola

At the early stage of secondary syphilis, in the vast majority of cases, patients are diagnosed with syphilitic roseola on the skin and mucous membranes. Externally, the formation looks like a spot, the size of which varies from 2.5 mm to 1 cm in diameter. The coloring also varies quite a bit. Roseolas are pale pink or purplish red. When pressed, round or elongated spots disappear, and pain is completely absent.

Syphilitic roseola occurs as a result of deterioration of blood vessels and a deficiency of red blood cells. A lack of red blood cells causes the inability to optimal provision tissues with molecular oxygen. Stagnation occurs in the subcutaneous tissue, causing the grayish-yellow color of old spots. Syphilis on the skin and mucous membranes is characterized by various shapes and sizes of roseola. What are the main differences:

• Rashes on the skin may rise slightly above their surface. Often scaly roseola is localized on the torso, chest, abdomen, palms, soles, and sometimes affects the face, especially the forehead. During relapses, rashes often merge with each other, forming one large spot. At the same time, the color of an extensive formation is expressed much less poorly than a small scattered rash;
• Syphilitic roseola rarely affects the mucous membranes of the genital organs. They are found in the mouth, nose, and upper respiratory tract. The rashes are visualized as large red-blue spots with clearly defined boundaries. Syphilitic roseola does not itch, and when pressed, a person does not experience any painful sensations. When a rash forms on the mucous membranes of the nasal passages, dry crusts often form as a result of swelling and impaired microcirculation. This causes nasal congestion and difficulty breathing.

Before making an initial diagnosis, patients are examined and laboratory tests are ordered. Based on their results, venereologists differentiate syphiloma from pediculosis pubis, pityriasis versicolor, as well as infectious and autoimmune skin lesions.

Papular syphilides

Cutaneous syphilis at the secondary stage of venereal pathology is almost always accompanied by the formation of dermal papules. They look like small dense capsules with liquid contents and are located directly in the upper layer of the epidermis. Typically, venereologists diagnose such rashes on the stomach, back, face, limbs, palms, soles and even on the scalp. Papular syphilides also affect the mucous membranes of the genitals, mouth, and nose. This type of skin rash becomes the most pronounced symptom of syphilis. The following symptoms are characteristic of papular syphilides:

• absence of roughness and presence of a shiny, smooth surface;
• pale pink, copper or bluish-red color;
• oval, slightly or strongly elongated shape;
• location isolated from each other, the possibility of merging when localized in skin folds;
• the resorption process begins from the middle of the formations, which provokes the appearance of various shapes on the skin of the infected person;
• the appearance of erosions and ulceration with a deeper location of the rash or localization in skin folds.

Papular syphilides are highly contagious due to the presence of a significant content of infectious pathogens in them. During this period, sexually transmitted diseases are easily transmitted through sexual contact, shaking hands, and sharing utensils. The number of rashes gradually decreases, and they completely resolve several months after their appearance. After they disappear, the skin begins to peel off greatly, and pigmented areas of the dermis remain at the locations of the papules.

Clinical picture of the third stage

Clinical manifestations of tertiary, or late, syphilis are characterized by a high degree of severity and the resulting irreversible destructive and degenerative changes in the skin and mucous membranes. The main cause of symptoms is not Treponema pallidum, which has lost its antigenic activity, but a distorted response of the immune system at the cellular level. Tissue proliferation through cell multiplication by division and their deformation provokes the formation of infectious granulomas:

• gumm;
• tubercular syphilides.

A feature of this stage of syphilis is damaged blood vessels, slow regeneration as a result of impaired blood supply to tissues with molecular oxygen, nutrients and biological active substances.

Syphilis pathogens activated at the local level provoke the development of tertiary chancre. If treatment for sexually transmitted pathology has not been carried out, then this period begins immediately after the completion of the second stage. If incorrectly compiled therapeutic regimen or stop taking pharmacological drugs before full recovery Several years may pass between the second and third stages.

Gummas and tubercular syphilides belong to specific elements and are not highly infectious due to the small number of gram-negative spirochetes in them. As soon as the infiltrate disintegrates, Treponema pallidum quickly dies. During the regeneration of skin areas where tertiary syphilides were localized, all layers of the epidermis atrophy. Large star-shaped scars form. The inflammatory process can only occur with an associated bacterial infection, but this condition is diagnosed extremely rarely.

The syphilitic rash of the tertiary period is reversible and gradually disappears after therapy. The severity of skin manifestations is directly dependent on the functioning of the infected person’s immune system, the number of complications that have developed and the presence of a history of chronic pathologies liver and kidneys.

Gunma

Gummas are formed in the form of single formations or located in small groups. They lie in the deepest layers of the epidermis, but can be located directly under the skin in fatty tissue. The rashes are localized in the following areas of the body of a sick person:

• mucous membranes of the nasopharynx, larynx, and other upper respiratory tract;
• forearms, ankles, face;
• elbow and knee joints;
• bone tissue of the head.

At the initial stage of gumma formation, a small nodular compaction is formed. Then there is a gradual increase in the infiltrate and its merging with the epidermis. The skin becomes thinner, stretches, and turns red-blue. The compaction rapidly increases to the size of a large walnut. The opened gumma secretes a viscous, transparent, foul-smelling liquid. In its place, a large ulcer with yellow-green contents forms. Necrotic masses begin to form in the depths of the gumma, and after this stage is completed, the open wound has clear boundaries and a dense bottom.

Tuberous syphilides

The third stage of syphilis is characterized by lesions of the skin and mucous membranes in the form of compacted round nodules. They appear in large groups, and after 1-2 months they begin to regress. At the stage of exacerbation of venereal pathology, new tuberculate syphilides are formed. Thus, doctors detect nodules in the infected person at various stages of formation, as well as multiple consequences of their decay and healing - pigmented spots and scars. The location of tubercular syphilides most often becomes:

• forehead, nose;
• back;
• knee and elbow joints;
• mucous membranes.

There is no pain when touching or pressing on syphilitic rashes. Tuberous syphilides have a hemispherical shape and are colored bluish-red with a predominant copper tint. The peculiarity of these rashes is the impossibility of their merging with each other and forming a large conglomerate.

“Note: Since specific antibodies to Treponema pallidum are produced immune system in small quantities, the results of serological laboratory tests are often negative. At the tertiary stage of syphilis, the leading diagnostic method is treponemal testing.”

What is chancre

Ways of transmission of infection:

The statement that syphilis is exclusively a disease that is sexually transmitted is not entirely true. The fact is that you can become infected with it in everyday life when the infection directly enters the bloodstream through scratches or wounds on the body; this is also possible when using toilet items (towel, washcloth) belonging to the patient.

In addition, infection with syphilis can occur through blood transfusion, and syphilis can also be congenital. Basically, the rash is located in the areas of hair and steps, as well as on the palms.

In addition, in women it is also localized under the mammary glands; for both sexes, its concentration can be located in the genital area.

After 3-4 weeks from the moment of infection, the place where Treponema pallidum, the causative agent of infection of this disease (which is mainly the genitals), was introduced acquires signs indicating primary syphilis.

Chancre is primary lesion on the skin with syphilis. It usually appears 18-21 days after infection; until this time the disease is not recognized and doctors talk about the incubation period.

Syphilitic chancre appears as a small reddish papule or slight superficial erosion. Over the course of a few days, the formation increases to several centimeters in diameter (2-3), and serous fluid oozes from the ulcer.

In women, the first genital chancre can be located in the vagina or on the cervix, in men on both sides of the frenulum. Extragenital chancre can be found on the lips, tongue, tonsils, chest, fingers and anus.

Chancroid is also similar to syphilis, but it is a completely different sexually transmitted disease, which is caused by Haemophilus ducreyi. It is usually detected in women and men 4 to 10 days after infection. The photo shows its signs, which include:

• Open wounds on the penis (as shown in the picture), around the opening of the vagina, in the rectal area, which are very painful.
• Presence of pus in ulcers.
• Soft edges of ulcers.
• Swollen glands in the groin.

Chancroid is sometimes also confused with herpes, so only a doctor, after research in the laboratory, makes an accurate diagnosis, excluding syphilis.

In the second stage of syphilis, ulcers appear in the mouth and throat area. On the tongue they may be ragged, with a hard base.

Around the same time, syphilitic roseola appears on the penis, chest, arms and forehead. They are painted dark red or copper.

They last on the body for up to two weeks, although it is possible that they lasted up to 2-3 months.

The third period of the disease is accompanied by syphilitic gummas. They form on the mucous membranes, skin, and subcutaneous tissues.

Gummas often affect muscles, internal organs, and bones. In the muscles they develop as tumors, on the surface as ulcers.

On internal organs they resemble fibroids, and on bones they resemble nodes. These formations are painful.

The pain is especially felt at night. Gummous syphilis even in the photo looks terrifying.

His most terrible act is the destruction of the brain and skull.

Chancroid with syphilis is called bright red ulcers in the mouth, as in the photo, with a hard or soft bottom and clear boundaries.

Types and course of syphilis

After the infection has entered the human body, the incubation period of syphilis begins, which according to various sources lasts from several days to 6 weeks, but on average - three weeks.

During this period, a gradual growth of treponema pallidum cells is observed, which, however, is not accompanied by the appearance of any symptoms. This period is dangerous because a person, unaware of his illness, becomes a carrier and distributor of the disease.

The causative agent of syphilis is treponema pallidum(Treponema pallidum), which belongs to microorganisms from the order of spirochetes. It multiplies quite quickly in the human body, but is vulnerable to the environment.

The spiral-shaped microorganism dies when boiled, and under the influence of a temperature of 55 * it is destroyed in 10-15 minutes. Also, treponema will not be able to survive when the liquid dries out, but on the surface of wet dishes it can survive for several hours.

When the temperature drops, even to -78*, the spirochete still remains active.

There are several classifications of the disease:

• According to the stage of development, syphilis is primary, secondary and tertiary.
• By origin - acquired and congenital;
• According to the timing of appearance - early and late.

Atypical syphilis

On this moment More and more often, doctors are diagnosing cases of latent syphilis. The reason for the situation is that antibiotics are now quite widely used. A person who experiences unpleasant symptoms may begin self-treatment suspected gonorrhea or trichomoniasis, and as a result, “score” the symptoms of the underlying disease. The following subtypes of latent syphilis are distinguished:

• Transfusion. The manifestation of the disease begins immediately from the second stage (approximately 2-2.5 months from the moment of infection). In this case, there is no formation of hard chancre.
• Erased. Symptoms of secondary syphilis are either erased or completely absent. The patient immediately develops asymptomatic meningitis and neurosyphilis.
• Malignant. This form of the disease is characterized by a rather rapid development. In addition, the patient is diagnosed with a decrease in hemoglobin, exhaustion of the body, and the formation of gangrene of chancre.

Congenital syphilis

The disease can be transmitted from an infected mother to the fetus as early as 10-16 weeks of pregnancy. Complications include spontaneous abortion or fetal death. By time, congenital syphilis is divided into early and late. In the first case, children experience the following violations and changes:

• Deformed skull, which is combined with dropsy and meningitis.
• Inflammation of the cornea of ​​the eyes;
• Underweight;
• Wrinkled face, like that of old people;
• Syphilitic rash around the genitals, anus, and mucous membranes of the throat and nose (at the age of 1-2 years).
• Rhinitis with purulent discharge from the nose;
• Inflammation and destruction of cartilage, bones and periosteum.

The late period of development of the disease in a child most often manifests itself at the age of 10-16 years. The following violations appear:

• Decreased visual acuity, up to complete blindness;
• Inflammation of the inner ear, which often results in deafness;
• Violation of the structure of the teeth (the upper incisors have a crescent shape);
• Nose deformity;
• Curvature of the lower leg;
• The appearance of neurosyphilis with speech impairment, epilepsy, paralysis.

There are such types of rashes with syphilis:

• First stage. The manifestation of this stage can be noticed a month after the infection was introduced into the body. At this moment, the first signs of syphilis can be observed. The rash appears as red pimples, which after a certain time take on the appearance of ulcers. The rash may disappear after a couple of weeks, but will soon reappear. Such a rash can remain on the human body for a long time, even be present for several years.

There are two types of syphilis: congenital and acquired. Further, in accordance with the symptoms, it is classified:

• Primary syphilis (syphilis I primaria);
• Secondary fresh syphilis (syphilis II recens);
• Early latent form;
• Secondary recurrent syphilis;
• Secondary relapse;
• Late latent form;
• Tertiary syphilis;
• Fetal syphilis;
• Early congenital syphilis;
• Late congenital syphilis;
• Latent congenital syphilis;
• Visceral syphilis;
• Neurosyphilis.

Different syphilides have and different features: They look, position and develop with some differences. Let us briefly consider each type of tertiary syphilitic formations.

Tuberous syphilide

This intradermal nodular inflammatory formation is the most common manifestation of tertiary syphilis.

Description: in the photo, tubercular syphilide looks like a smooth, shiny pea of ​​dark red color with a yellowish or bluish tint.

Stages of the disease

The manifestation of syphilis in women on the lips can take the form of large inflamed skin lesions, from which pus or blood often oozes. Such skin lesions can only be eliminated by surgery.

Develops in the absence adequate treatment 6-10 or more years after infection. The main morphological elements of this stage are syphilitic gumma, syphilitic tubercle.

As a rule, at this stage, patients are concerned about severe aesthetic defects that form during the active course of syphilis.

Elements of the third stage of syphilis:

1. Tuberous syphilide is a dense tubercle of a cyanotic hue, which can necrotize according to the coagulation type, resulting in the formation of an area of ​​tissue atrophy. With liquefaction necrosis, an ulcerative defect is formed on the surface of the tubercle, in place of which, during the healing process, dense, receding scars are formed. Along the periphery of the resolving tubercles, new tubercles are formed that do not merge with each other.
2. Gummous syphilide is a node that forms in the subcutaneous fat. In the center of the node, a center of tissue melting is determined, a hole is formed on the surface of the skin, through which exudate is released from the center of the gum. The size of the presented hole gradually increases, as necrotic processes are activated, and a gummous core is formed in the center of the lesion. After its rejection, the ulcer regenerates with the formation of a deep retracted scar.

The photograph shows a star-shaped scar in the nasal area, which forms after the healing of an ulcer in the tertiary period of syphilis.

Signs of primary syphilis include the appearance of a red spot small sizes, 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, chancre.

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

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

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

Signs of the general type of secondary stage of syphilis include the following features of the rash:

• Absence of subjective sensations (pain, itching);
• Dark red color of the rash;
• Density;
• Clarity and regularity of roundness or roundness of outlines without their tendency to possibly merge;
• Peeling of the surface is of an unexpressed nature (in most cases its absence is noted);
• Spontaneous disappearance of formations is possible without subsequent atrophy and scarring.

Most often, rashes of the secondary stage of syphilis are characterized by the following manifestations (see photo of a syphilitic rash):

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

This circumstance leads to the fact that even with the influence of a small amount of treponemes, the body responds with a peculiar form of anaphylactic reaction, which consists in the formation of tertiary syphilides (gummas and tubercles).

Their subsequent breakdown occurs in such a way that characteristic scars remain on the skin. The duration of this stage can be decades, which ends with deep damage to the nervous system.

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

Tubercular syphilis is determined by palpating the thickness of the skin and identifying a dense formation in it. It has a hemispherical surface, the diameter is about 0.3-1 cm.

Above the tubercle, the skin becomes bluish-reddish in color. The tubercles appear at different times, grouping into rings.

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

Gummy syphilide is a painless dense node that is located in the middle of the deep skin layers. The diameter of such a node is up to 1.5 cm, and the skin above it acquires a dark red tint.

Over time, the gum softens, after which it opens, releasing a sticky mass. The ulcer that formed in this case, without carrying out necessary treatment can exist for a very long time, but at the same time it will increase in size.

Most often, such a rash is single.

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

Photos of people with syphilis demonstrate how chancre develops and what they can grow into if treatment is not provided in time. The most common type of chancre in the secondary stage of syphilis is considered to be a deep ulcerative lesion that can release lymph or pus when pressed.

Advanced stages of syphilis cause extensive tissue damage, serious swelling and inflammatory processes in the skin

Skin manifestations of syphilis at the primary stage may also look like single ulcers, which subsequently spread to healthy areas of the body.

There are several stages through which patients infected with syphilis go:

Usually, ulcerative lesions skin in the last stage of syphilis appear in an aggressive form and affect the deep layers of the skin. Chancres on the tongue at this stage of the disease look like deep funnels with uneven edges and a purulent base.

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

Chancre - features

In the photo, the chancre looks like a regular ulcer: it is round or oval in shape, bluish-red in color with a sore in the center. If the ulcer is not deep, it is called erosion. To the touch, a chancre is a hard formation; it feels like cartilage. The surface of the chancre is usually moist.

The location of the chancre can be:

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

There are three stages. The photo above clearly shows the first symptoms of syphilis at the secondary stage.

IT IS IMPORTANT TO KNOW!

Syphilis of the extremities often leads to the development of deep tissue lesions, which can no longer be cured by drug intervention in the second or third stage of their development.

In the secondary or tertiary stages of development, the syphilis rash can affect large areas of the skin and turn into huge purple affected areas with inflamed edges.

In total, doctors distinguish three stages of the disease, which differ in clinical course and symptoms. To correctly make a diagnosis, a qualified venereologist only needs a visual examination and collection of a medical history.

In this case, laboratory tests will be needed to confirm the type of pathogen and eliminate doubts regarding the chosen treatment tactics.

Primary syphilis

The first stage of syphilis begins with the formation of erosion or ulcers, which range in size from several millimeters to several centimeters. In medicine, such rashes are called chancre. This is the very first sign of syphilis, which will persist for 10-14 days.

Some men think that syphilis rashes only cover the surface of the penis or other genital organs (testicles, scrotum, etc.). This is wrong.

The ulcer may appear on the back, arms, palms, and stomach. In some cases, hard chancre forms on the surface of the mucous membranes, especially in the oral cavity, since it is an excellent breeding ground for the proliferation of all types of bacteria and microorganisms.

The formation of chancre is usually not accompanied by other symptoms, so many men do not consult a specialist at this stage of the disease. IN in rare cases a man may experience weakness, malaise, and loss of strength, but most often this is due to fatigue and other unfavorable factors. By the end of the second week after the formation of the ulcer, other symptoms of syphilis appear, which include:

• enlarged lymph nodes in the groin, neck and armpits;
• changes in mood (irritability, anxiety, aggression);
• problems with appetite;
• painful sensations in the joints;
• slight increase in temperature (up to 37.5°).

In most cases, swelling is observed in the genital area. If there is a large area of ​​edema, pain and discomfort may occur while walking.

Important! If the patient does not receive treatment at the primary stage of syphilis, the disease becomes chronic, and the patient begins a period of attenuation, which can last up to 2 months. After this period, the infection will occur with periods of remission.

Secondary syphilis

This stage can last up to several years, while the infectious agent, while in the body, affects all organs and systems of the male body. The heart and nervous system suffer the most, so a man with secondary syphilis is often diagnosed with the following symptoms:

• sudden attacks of fear and anxiety;
• sudden change of mood;
• dyspnea;
• angina pectoris;
• tachycardia;
• heart rhythm disturbance.

The main symptom at the secondary stage is a rash, which may appear and go away on its own. This is the main danger of the disease - men often mistake such signs for an allergic reaction or manifestations skin dermatitis, so they don't pay attention to them.

Important! The rash of syphilis has characteristic features, so it can be distinguished from dermatological diseases. During relapses, rashes are brightly colored and symmetrical in shape (resemble small nodules).

In some men, secondary syphilis may result in partial or complete alopecia (hair loss). Hair can fall out not only on the head - diffuse forms of baldness in men are diagnosed in groin area, under the arms and on the surface of the legs.

Only a qualified doctor can correctly determine the cause of alopecia, so this problem should be addressed to a hospital, and not to cosmetologists.

Tertiary syphilis

Stage I. Latent (asymptomatic) syphilitic meningitis.

Stage II. Damage to the meninges (meningeal symptom complex).

Damage to the soft and hard membranes of the brain: acute syphilitic meningitis, basal meningitis, local damage to the membrane of the brain.

Damage to the soft and hard membranes of the spinal cord, its substance and spinal roots - syphilitic meningoradiculitis and meningomyelitis.

Stage III. Vascular lesions(secondary and tertiary periods of syphilis). More often there is simultaneous damage to the soft meninges and blood vessels of the brain - meningovascular syphilis.

Stage IV. Late neurosyphilis (tertiary period of syphilis). There are late latent syphilitic meningitis, late vascular and diffuse meningovascular syphilis, tabes dorsalis, progressive paralysis, taboparalysis, gumma cerebri.

Rice. 3. Nietzsche, V. Lenin and Al Capone suffered from neurosyphilis.

A form of syphilis in newborns that is not diagnosed in time can provoke the spread of infection throughout the child’s body, cause the appearance of multiple rashes in the area of ​​the forearms and back, and inflame the lymph nodes.

The tertiary period of syphilis is the last, 3rd stage of the disease, which always and inevitably develops if syphilis is not treated. However, the time for the development of the tertiary stage of syphilis is different for everyone.

• In 10-20% of cases, the first signs of tertiary syphilis appear 3-5 years after infection;
• in 65-85% - after 10 years or more;
• and somewhere in 5-10% – already 2 years after infection.

Signs of household syphilis

The course of syphilis can be divided into 4 stages: primary, secondary, latent and tertiary. Immediately after infection with this disease, the incubation period begins, which can last from 9 to 90 days (the average is about 3 weeks), when the first characteristic signs and symptoms begin to appear.

During the incubation period, a person who has received treponema into his body is not yet infectious to others. This time lasts until the first signs of the disease appear.

Each stage has its own essential external signs, however, they may be found differently in different people or have a number of associated manifestations.

Early syphilis is usually missed and not diagnosed, because people don’t know what the first signs of syphilis are, even in photographs, and they are still practically not felt on the body.

People see no reason to be alarmed enough to see a doctor. A small ulcer in the genital area usually does not cause pain, and it will soon close and heal on its own, but this already indicates the development of the disease.

In women, the first signs of syphilis are already noticeable a couple of weeks after infection. Ulcers appear in a woman in the area of ​​the labia and vaginal mucosa. However, they can also form on other parts of the body.

There are cases when the disease proceeds completely invisible. The only thing you should pay attention to is general health and lymph nodes.

In the first stage of the disease, only some lymph nodes become enlarged. You should also consult a doctor if you feel weak and unwell.

The second stage of syphilis in women is characterized by enlarged lymph nodes throughout the body. In addition, there is a headache, aches, skin rash, a feeling of pain in the bones, as well as an increase in temperature.

The development of the disease can lead to loss of eyelashes and eyebrows. At the third stage of syphilis development, all internal organs are affected.

Syphilis is especially dangerous during pregnancy. An infected woman can bear a child with special pathologies, which sometimes may be incompatible with life. She may also give birth to a stillborn baby.

The incubation period for this disease can last from three to six weeks. As already mentioned, the first sign of the disease is an ulcer, which has round shape and in diameter can range from half a centimeter to two centimeters.

This ulcer has a smooth, shiny bottom and hard edges. Then the lymph nodes in the affected area gradually enlarge.

After two or three months, a characteristic rash appears, which may take the form of blisters or dark red spots. Sometimes the rash may be accompanied by itching.

With syphilis, a woman usually feels a sore throat, malaise and fever.

Photos of patients. What do skin lesions look like?

With the disease in question, the spots on the patient’s body differ in several characteristic features, among which are the following:

1. The rashes are usually not localized to a specific area of ​​the body; they can appear anywhere.
2. The affected areas do not itch, itch or hurt, and there is no peeling.
3. The elements on the body are dense to the touch, round in shape, and can be single or merge with each other.
4. A syphilitic rash may be pink or red with a blue tint.
5. After the rash disappears, no marks or scars remain on the skin.

The attached photo clearly shows what a syphilitic rash looks like, which is difficult to confuse with any other.

It is worth saying that the photos show symptoms household syphilis are no different from the symptoms of syphilis, which is sexually transmitted. The infection affects the skin and is difficult to diagnose at the initial stage, since it resembles a skin fungus rather than a sexually transmitted disease.

You can suspect syphilis by thickening and swelling of the foreskin. Soon the spots and ulcers shown in the photo appear, which may disappear after a certain time, but then appear with renewed vigor.

Within a couple of weeks after infection, the woman begins to experience general malaise, ulcers appear on the genitals, and regional lymph nodes become enlarged. If it is cutaneous syphilis, as in the photo, a rash is observed.

Late forms of syphilis have become increasingly rare in many countries around the world in recent decades. This is facilitated by the widespread use of antibacterial drugs, improved diagnostics and therapy.

Among patients with neurosyphilis, tabes dorsalis and progressive paralysis are becoming less common. The incidence of meningovascular syphilis is increasing.

Late forms of neurosyphilis often develop in patients who have been insufficiently treated or not treated for early syphilis. The development of the disease is facilitated by a decrease in immunity, which is negatively affected by physical and mental trauma, intoxication, allergies, etc.

The following forms of late neurosyphilis are distinguished:

• late hidden (latent) syphilitic meningitis,
• late diffuse meningovascular syphilis,
• vascular syphilis (syphilis of the brain vessels),
• tabes dorsalis,
• progressive paralysis,
• taboparalysis,
• gumma brain.

Late latent syphilitic meningitis

Before starting treatment for syphilis, it is worth correctly diagnosing it. So the most important sign of syphilis in a patient manifests itself in the form of a hard, dense chancre and a significant increase in the size of the lymph nodes.

Chankra - Photo of the initial stage

As we already know, the third (or tertiary) stage of syphilis can manifest itself not only on the skin, but also inside the body. With this progression of the disease, bumps and bumps form unpredictably in a variety of areas.

For example, directly inside organs, in the space between them, in the tissues of the nervous system, on the walls of large vessels, and so on.
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Let's look at the diseases that tertiary syphilis causes in more detail.

Tertiary neurosyphilis

This is a disease of the nervous system - the membranes, blood vessels and substance of the brain and spinal cord. Neurosyphilis develops in 30% of cases of the tertiary period. This is very dangerous condition which can lead to dementia, insanity, paralysis and disability.

Initial neurosyphilis may present with headaches, increased fatigue, absent-mindedness, memory and sleep disorders, numbness of the limbs, urination problems, and so on. In each specific case, the set of symptoms will be different. More information about neurosyphilis can be found in the material “Syphilis of the nervous system.”

Syphilis of the nervous system can lead to paralysis, insanity and disability

Tertiary syphilis of the cardiovascular system.

This damage to the heart and blood vessels is less common than neurosyphilis. Most often, in the late stages of syphilis, the aorta is affected. In this case, aortic valve insufficiency and stenosis may develop. coronary arteries and aortic aneurysm.

Aortic aneurysm is the most dangerous complication cardiovascular syphilis. It can lead to rupture of the aortic wall and instant death of the patient

Tertiary syphilis of bones and joints

If syphilis affects the bones and joints of a person, then they gradually become deformed - their shape and size change, cartilage and bone in those areas where gumma destruction occurred. As a result, the joints stop doing their job normally.

In addition, the cartilage of the facial area may be destroyed. Thus, the world-famous complications of syphilis are a saddle nose and a hole in the hard palate.

Tertiary syphilis of internal organs

In addition to the heart and blood vessels, syphilis in the tertiary period can affect almost any internal organ. This complication is called “late visceral syphilis” (late syphilis of the internal organs).

Visceral syphilis can affect the liver, kidneys, digestive system, internal genital organs, lungs, and so on.
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In each of these cases, patients develop different symptoms. Wherein internal mechanism disorders are similar: inside the organ, one or more syphilides first form, and after a while they begin to resolve.

Jonathan Getchinson, an English dermatologist, surgeon, syphilidologist and ophthalmologist in 1852 described the symptoms of late congenital syphilis - labyrinthine deafness, parenchymal keratitis and dental damage.

At the suggestion of the French dermatologist and venereologist A. Fournier, these signs began to be called Hutchinson’s triad.

Some symptoms of tabes dorsalis are also named after this scientist.

Rice. 2. Pictured is Jonathan Getchinson.

Abnormalities of dental development in congenital syphilis

The triad of congenital syphilis includes developmental anomalies (hypoplasia) of teeth. In children with congenital syphilis, pathologies such as Hutchinson, Fournier and Pfluger teeth are recorded.

The reason for the development of these hypoplasias is the effect of syphilitic infection on the metabolic processes in the rudiments of the teeth, resulting in the formation of a malformation of the organ.

• D. Getchinson first described special shape pathology of the central incisors, in which the semilunar notch of the incisal edge was determined. However this sign of congenital syphilis even D. Getchinson himself recognized it as reliable only in the presence of 2 more signs - deafness and parenchymal keratitis.
• A. Fournier pointed out that congenital syphilis is characterized not by a semilunar notch, but by a barrel-shaped crown, when the neck of the tooth is larger in size than the cutting edge in the absence of a semilunar notch.
• Another anomaly of dental development in congenital syphilis is Pfluger’s teeth. The pathology is characterized by damage exclusively to the first large molars - a wide neck of the tooth (wider than that of the chewing surface) and significantly underdeveloped cusps. In this case, the tooth takes on a kidney-shaped appearance.
• Pflüger's teeth, an additional cusp on the side of the tongue on the first molars (Carabelli cusp), thinning of the free edge of the canine (Fournier's pike tooth), purse-shaped canines, widely spaced teeth of the upper row, dwarf teeth and growth of teeth on the hard palate are probable signs congenital syphilis.

Possible signs of the disease require additional confirmation of the diagnosis from the doctor, as they can also occur in other diseases. When diagnosing, it is also necessary to take into account other specific manifestations of syphilis, anamnesis data and the results of an examination of the child’s family.

Chorioretinitis, nasal deformities and buttock-shaped skull, dental dystrophies, radial scars on the chin and around the lips, saber shins and gonitis are the main probable signs of congenital syphilis.

Saber shins

This pathology develops in infancy and accounts for about 60% of all lesions in late congenital syphilis. The disease affects the periosteum and bone tissue tibia(osteoperiostitis), as well as cartilage with the underlying portion of the bone (osteochondritis), which gradually bend under the weight of the child.

The bend is formed at the front and resembles a saber blade. The bones themselves lengthen and thicken.

The child is bothered by night pain. The bones of the forearm are somewhat less commonly affected.

The diagnosis is confirmed by x-ray. A similar picture is observed in Paget's disease.

With rickets, the bones bend outward.

Rice. 8. X-ray of saber-shaped shins (left) and ridge-shaped periostitis (right).

Rice. 9. In the photo there are saber-shaped shins of a child.

Syphilitic drives

Syphilitic drive was first described in 1886 by Cletton. Of all lesions in congenital syphilis, gonitis accounts for 9.5%.

When the disease affects the synovial membrane and bursa of the knees, less often the elbows and ankle joints. Cartilage and bone epiphyses are not affected.

The process is often bilateral, but first one joint becomes ill. Syphilitic drive occurs without fever, sharp pain and dysfunction.

The joints increase in volume, the skin over them does not change color. Liquid accumulates in the cavities.

The course is chronic. Resistance to specific therapy is noted.

The Wasserman reaction always gives a positive result.

Rice. 10. Syphilitic drive is a probable sign of late congenital syphilis. In the photo on the left, protrusions of the inversions of the synovial membranes of the articular capsules of the knee joints are visible.

Saddle nose

Deformation of the nose with congenital syphilis is recorded in 15 - 20% of cases and is a consequence of syphilitic rhinitis suffered at an early age.

The nose acquires a saddle shape as a result of the destruction of the nasal bones and nasal septum. The nose is sunken and the nostrils protrude.

Small cell diffuse infiltration and atrophy of the nasal mucosa and cartilage lead to the formation of a goatee or lorgnette nose.

Rice. 11. Consequences of late congenital syphilis - saddle nose.

Buttock-shaped skull

The buttock-shaped skull is formed in the first months of a child’s life. Periostitis and osteoperiostitis of the flat bones of the skull leads to a change in its configuration - the frontal tuberosities stand forward, between them there is a groove (buttock-shaped skull). With hydrocephalus, all sizes of the skull increase.

Rice. 12. The photo on the left shows enlarged frontal tubercles, the photo on the right shows a view of the skull with hydrocephalus

Robinson-Fournier scars

Robinson-Fournier scars are recorded in 19% of children with late congenital syphilis. Their cause is diffuse papular infiltration of Hochsinger suffered in infancy.

Radial scars are located on the chin, forehead, around the lips and corners of the mouth. Scars remain on the child’s skin after suffering from pyoderma, candidiasis and burns.

Rice. 13. The photo shows diffuse infiltration of Hochsinger’s skin in early congenital syphilis.

Dystrophic lesions of teeth

Pflueger's teeth (read above), an additional cusp on the side of the tongue on the first molars (Carabelli cusp), thinning of the free edge of the canine (Fournier's pike tooth), purse-shaped canines, widely spaced upper teeth, dwarf teeth and tooth growth on the hard palate are probable signs congenital syphilis.

Rice. 14. Carabelli tubercle - an additional tubercle located on the chewing surface of the first molar of the upper jaw (No. 5 in the figure). The anomaly is often bilateral.

Rice. 15. The photo shows widely spaced teeth and “Fournier pike teeth” in late congenital syphilis.

Lesions of the skeletal system

Osteoperiostitis and periostitis, gummous osteomyelitis and osteosclerosis are the main types of bone lesions, which occur in 40 - 50% of congenital syphilis. The lower legs (59%), nasal bones (18%), forearms (10%), skull bones (5%), and hard palate (4%) are affected.

Lesions of internal organs

Symptoms of tertiary syphilis are severe skin symptoms, severe complications from internal organs, and neurological pathologies. With a long course and inaction on the part of the patient, treponemal infection ends in death.

A typical sign of the last stage of the disease is tertiary syphilides - compactions and granulomas in any tissues and organs. These formations are noticeable only in the form of areas of compaction under the skin, which to the touch resemble tubercles or nodes, completely painless when touched or pressed.

Tuberous syphilides on the skin appear in the form of elevations up to a centimeter in size and are also distinguished by their color - a slight red or burgundy tint.

Symptoms in men

The incubation period of syphilis in men and women is not marked by any specific symptoms. In rare cases, a person may experience slight weakness and malaise, but these signs are most often attributed to fatigue after a hard day or a cold.

We can say with confidence that the disease begins with the appearance of a hard chancre on the body - an ulcer that occurs as a result of an immune response to the introduction of Treponema pallidum into the body - these are the first characteristic symptoms of syphilis.

This is how primary syphilis manifests itself. Sometimes a chancre may have an atypical appearance, which is explained by infection. In rare cases, in the genital area, since the disease is in most cases sexually transmitted, painless swelling appears with a change in the color of the tissue.

After some time, the lymph nodes enlarge at the site where chancre appears. They are painless and dense to the touch. During this period, a person may feel weak and suffer from fever - this is the second most important symptom of syphilis.

Secondary syphilis is characterized by rashes or small hemorrhages on the skin and mucous membranes, turning into condylomas, which are extremely contagious. At this stage, a person experiences enlarged but painless lymph nodes, increased body temperature, noticeable weakness, runny nose, cough, and conjunctivitis.

In some cases, a rash does not form, the disease looks like common cold, so diagnosing syphilis is difficult. Sometimes the disease is completely asymptomatic, which allows it to unnoticed become chronic.

not noted characteristic symptoms, it can last for years, affecting during this time all the internal organs of a person. The aorta is most affected large vessels, spinal cord and brain.

Since the disease becomes chronic and manifests itself with a decrease in immunity, with each new manifestation of the disease soft tumors - gummas - are formed in the organs and tissues, which over time turn into scars.

Often a man may not even be aware of his infection. Usually men don't pay attention special attention for skin rashes and other symptoms of this disease.

Moreover, the signs of syphilis disappear after some time. But this indicates the progression of the disease rather than its cure.

Given this, you should pay attention to obvious signs of syphilis (more details on photographs of patients can be found below).

First of all, in a man it thickens and swells. foreskin. In addition, a clear sign is the appearance of small ulcers in the genital area, urethra and anus.

Ulcers can also appear on other parts of the body. Such ulcers are called chancre.

They appear at the initial stage of the disease. Typically, the chancre takes on a round shape from one to four millimeters in diameter.

It has dense edges, red color and is characterized by painlessness. However, such ulcers are very insidious, since they are contagious to another person.

If an infection gets into the ulcer, tissue necrosis may begin.

About a week after the ulcers appear, the lymph nodes become enlarged and the temperature rises. However, the general well-being of a person remains more or less normal. At this moment, there are practically no sensations, and that is why a man does not always consult a doctor.

When the second stage of syphilis occurs, a rash appears on the skin. At the moment, this disease is already destroying the body.

If treatment is not provided to such a patient, after a few years the systems and organs of the male body will slowly begin to fail. At such times, a favorable treatment outcome is impossible.

That is why, for timely treatment, tests should be taken after casual sexual contact or at the first manifestations of the disease.

Some people are interested in how long it may take for the disease to manifest itself after unprotected sexual contact with a patient? Typically, the first signs of syphilis appear 4-6 weeks after infection.

In rare cases, this period can be reduced to several weeks or increased to three to four months. The duration of the incubation period may increase if the person was taking antibiotics at the time of infection.

In this case, the blood test for syphilis will be negative.

In the photo on the Internet you can see what syphilis looks like at different stages of the disease.

The symptoms of primary syphilis are as follows:

In women, as in men, there are three stages of syphilis: primary, secondary and tertiary. The disease progresses gradually; the incubation period in women is often prolonged due to various factors, for example, taking antibiotics.

Primary syphilis in women is characterized by the following symptoms:

Symptoms of primary syphilis

With acquired syphilis, the average incubation period is about 30 days (less often 15-20 days or several months).

Note: the reason for the longer latent period is the use of small doses of medications that inhibit the pathogen after infection with Treponema pallidum.

One of the most dangerous sexually transmitted diseases known to mankind is lues. This disease, better known as syphilis, is transmitted not only through sexual contact, but also during household contact - through personal hygiene items.

There are cases of contracting an infectious disease through blood transfusion. A sexually transmitted disease develops as a result of the pathogen syphilis entering the body.

Penetrating into the human body, it leads to various lesions and skin manifestations of syphilis. Infection is fraught with the fact that a complete recovery is possible only at an early stage. The spiral-shaped microorganism rapidly develops in the body, damaging and affecting vital organs and tissues.

The causative agent of an infectious sexually transmitted disease can affect human skin in different ways. As a rule, a rash appears on the body, located on the soles of the feet and in the genital area. In women, such manifestations can also be found in the chest area, but the main foci continue to be the genital areas. White treponema is able to retain its infectious properties for quite a long time even at low temperatures.

The causative agents of syphilis are dangerous because they are not detected at an early stage and it is possible to eliminate foci of the pathogen only at an elevated temperature of up to 100 degrees, treatment various solutions acids and alkalis. But in no case should you perform independent treatment, as you can only do harm.

Skin manifestations

A clear symptom of syphilis is a skin disease. During penetration pathogen into the human body, the first ones begin to appear. Many people are interested in the important question of how syphilis manifests itself, but it is not possible to answer unequivocally, since the manifestations at each stage differ from each other.

What syphilis will look like on the skin can be seen at an early stage infectious disease. A hard chancre begins to form, which may disappear without a trace in subsequent stages. The disappearance of such symptoms does not mean that the disease has passed; it may be chronic. Thus, if the disease is not expressed externally, this may mean that the process of developing a terrible disease has begun in the body.

After infection and spread of white treponema through the bloodstream, the body begins to intensively fight the infectious lesion. The active phase of the immune system's fight against microorganisms smoothly flows into the second phase of the disease. An example of the interaction of antibodies with white treponema is syphilides.

This skin manifestation of syphilis can be localized in the chest area, on the arms, and also have a different color and size. Some of the manifestations can cause discomfort and even pain. Most people infected with syphilis note that they even feel itching and burning. What syphilis looks like can be observed already in the second stage of the disease.

Chancres usually appear on the human body, similar to ulcers. These ulcers have an unpleasant appearance, and purulent discharge regularly appears from them. They can be dark red or purple. As a complication of syphilis, spots develop into lesions with a bloody bottom, which become crusty.

Such unpleasant formations most often appear when the stage of the disease is already advanced. In this case, all the skin on the back and abdomen is covered acne, representing discomfort for a patient with syphilis. In men, after infection, a rash appears on the genitals and can cause discomfort. Since the symptoms are similar to other diseases, many people do not take them seriously.

What does syphilis look like?

When infected through personal hygiene items (washcloths, dishes, towels), ulcers appear on the hands, in the oral and nasal cavities. This type of ulcer looks more like blisters, with purulent discharge. It must be remembered that getting rid of such abscesses is not easy and there is no need to self-medicate. The situation may worsen with the appearance of purulent formations, as they become infectious to those who come into contact with the patient.

Secondary syphilis of the skin and mucous membranes

As already described above, characteristic feature syphilis during the secondary stage are manifestations on the skin. Despite the fact that the rash does not cause discomfort, if it appears, you should consult a specialist. On average, after 10 weeks, pain begins to appear when pressing on it.

A similar rash appears in those areas that have become infected. Most often, such areas are the mucous membranes, folds, and locations of the genitalia in men and women. Symptoms include the appearance of tumors in the genital organs and hair loss, which is an unpleasant process especially for the female half of the population. Thus, syphilis can vary and have characteristic features, all depending on the method of infection.

If you look at syphilis, you will notice that the spots and chancre are small, pale red lesions that can disappear on their own without any intervention. Erosion on the skin is localized on the pubis in women, genitals in men, and even on the mucous membranes. Multiple ulcers on the mucous membranes are also signs of syphilis, resembling small warts.

In fact, it is very difficult to distinguish the symptoms at an early stage, given that the symptoms have similarities with other diseases. But you should pay attention to the similarities of symptoms and then it will be easier to establish a diagnosis. With syphilis, new formations have an individual color, gradually changing from pink to dark scarlet, and then acquiring a pale tint.

The next similarities of syphilis are the fact that syphilides have smooth edges and do not mix with other formations and do not peel off. These syphilides range in size from one to two millimeters. The third and most noticeable fact is the disappearance of manifestations without leaving marks or scars on the skin.

Skin rashes with syphilis during the secondary stage may have various variations. The variants of syphilis are very diverse - roseola, spots, papules, rashes on the palms and soles of the feet.

Almost 75% of patients with syphilis develop so-called roseola. These symptoms indicate that the infection has begun to spread throughout the body. Roseolas are formations on the skin that are not particularly inflamed. They are round in shape and pale - pink color. It must be pointed out that they do not extend to the human body and are located on the stomach and torso.

Papules

On the skin of a patient with syphilis, they can take the shape of a pea and have compacted contents. If roseola does not peel off, then papules are characterized by a surface without tubercles and having a certain shine. After some time, these papules begin to itch and peel. This form is also located in the genital area, as well as on the palms and soles of the feet. On the soles, papules are compactions with properties similar to calluses. Often, as the disease progresses, palmar-plantar syphilide begins to crack and peel.

Condylomas

It is worth noting that condylomas are the result of improper and untimely treatment papules Condylomas are characterized by merging with other formations on the skin. This form is the most complex and neglected option venereal disease, since with condylomas the affected surface is covered with a pale coating with unpleasant discharge.

Sore throat, often called erythematous, appears in the oral and nasal cavities. In these areas, the appearances are reddish, even copper in color, with clear outlines. Despite the fact that special pain is not observed, some patients indicate that some discomfort occurs during meals.

Formations that are called syphilitic leukoderma (necklace of Venus), located in the neck area. The pigmentation has a pronounced yellowish color, without burning or itching.

Thus, we examined that despite the secretive nature of the symptoms of a sexually transmitted disease, they make themselves felt and become a signal to seek help from a doctor. In this article you can see and consider the symptoms of skin manifestations using the example of syphilis (photo), which will allow many to understand the signals of their body in time and prevent irreversible consequences.

Among all sexually transmitted diseases with predominantly sexual transmission, cutaneous syphilis is one of the most dangerous. Due to recurrent, varied symptoms, which quite often go unnoticed by patients until the onset of severe damage to the body, detection of treponemal infection in more than 67% of patients occurs only with secondary or.

The main reason for late visits to medical institutions is mild symptoms that can be mistaken for colds or flu.

In the case of skin manifestations of syphilitic infection, patients often do not associate these signs with possible infection venereal disease and engage in self-therapy for a long time. Due to the fact that the course of syphilis also has its own differences, skin manifestations appear strictly at certain stages of the disease. That is why, if any manifestations are detected on the skin or mucous membranes that are similar in appearance to syphilitic ones, doctors carry out full examination patient.

Cutaneous syphilis is not a separate disease, as many people think. Skin manifestations are one of the types of symptomatic signs of damage and spread of treponemal infection. Therefore, in total diagnostic examination and examination, manifestations on the skin should not be ignored.

In this article we will answer questions about how exactly one can recognize the manifestations of syphilis on the skin, what changes are observed at different stages of the disease, and what needs to be done if a treponemal infection is suspected.

Treponema pallidum or spirochete pallidum is an anaerobic, gram-negative organism. In total, 4 types of spirochetes are known that are pathogenic for humans, and only one subspecies, T. pallidum pallidum, is the causative agent of syphilitic infection. The characteristic biological properties of this pathogen are that treponema does not require oxygen to reproduce, but in moderately humid and warm environments they maintain their viability well. Treponema survival is also observed during freezing.

In case we're talking about about cutaneous syphilis, we mean a syphilitic infection with predominantly skin manifestations. Treponema infection is characterized by sexual transmission, through direct contact with the environment in which pale spirochetes. During unprotected sexual intercourse, if treponemas from an infected person get on tissues or mucous membranes healthy person through the smallest defects in the skin or mucous tissues, the pathogen quickly penetrates the body and then spreads through the lymphatic drainage pathways to all organs and systems.

Infection with Treponema pallidum can occur not only during vaginal, but also during anal and oral sex, since the area or location on the body does not matter for the penetration of the pathogen through tissue.

In the body of an infected person, treponema in biological fluids, in semen or vaginal fluid, or in breast milk can become a source of infection. IN living conditions contact with personal belongings, a razor or blade, a toothbrush and washcloth, or a towel can also cause infection. For employees of medical institutions, junior and senior medical personnel, the risk of infection may be contact with instruments, syringes and bandages of a person with a confirmed syphilitic infection.

Skin manifestations at different stages of the disease

Cutaneous syphilis is not a completely correct term for certain formations on the skin that appear after treponemes penetrate the human body and the end of their incubation period. Upon initial entry into the internal environment, into the bloodstream and lymphatic systems, the incubation period of the pathogen is observed for 20-50 days, that is, its spread throughout all organs and systems. In this case, there are no manifestations on the skin, and patients may not be aware of their infection with a sexually transmitted disease.

During treatment with certain antibacterial or hormonal drugs, the incubation period of treponemes can be extended to several months. This is precisely why incubation syphilis is dangerous - the zero stage of the disease, in which the Wasserman test is still negative, and when taking tests a false result is given. And only upon transition to the first symptoms appear in the form of the formation of hard chancre. At this stage they say that it is cutaneous syphilis. That is why, in order to make a reliable diagnosis and exclude such results as or negative during the incubation period, venereologists conduct only a comprehensive examination.

In the primary stage of syphilitic infection, they are completely painless, dense ulcers that do not exceed a few centimeters and are located at the site of penetration of the treponemal infection into the human body. Therefore, depending on the method of transmission of the pathogen, when skin chancre is detected, a transmission route can be assumed.

Most often, these formations are found on the genitals and mucous membranes, in the rectum or on the oral mucosa. After the appearance of ulcers, an increase and pain in the lymph nodes closest to the site of inflammation are observed.

IT IS IMPORTANT TO KNOW!

In cases where the entrance gates for treponemal infection were the tissues and mucous membranes of the oral cavity, then severe pain and ulcers on the walls of the pharynx and tonsils, reminiscent of a sore throat in symptoms, may be observed. If the entrance gate of infection was the mucous membranes of the lips, characteristic ulcers appear in the labial area.

The course of untreated syphilis and false syphilis

As the disease progresses, the course of untreated syphilis becomes more pronounced. The disease progresses to the second stage - the stage of secondary syphilis. The test for syphilis in this case is undoubtedly positive, which greatly facilitates diagnosis for venereologists.

In the secondary stage of treponemal infection, hard chancre disappears on its own, but instead of ulcerative formations, a small and medium-spotted rash appears on the body in the form of small formations, papules and pustules. There is also a significant deterioration general condition, progressive weakness and fatigue. There may be fever, joint pain and aches, similar to symptoms of influenza and acute respiratory viral infections.

A separate manifestation of the secondary stage can be considered the appearance of a rash on the inner surface of the arms and palms, which makes it possible to clearly identify syphilis on the palms. However, given the various skin manifestations of treponemal infection, only an experienced venereologist will be able to correctly differentiate these rashes from other diseases.

When syphilis appears on the skin, completely painless, non-itchy red rashes are observed on the palms of a person. They are quite dense in structure and are located somewhat separately, without merging with each other. Also, skin manifestations of secondary syphilis do not peel or itch. After a certain period of time, they go away on their own, which is a sign of the disease entering the latent phase, when the latent course of the disease is determined.

The transition of treponemal infection from the stage of secondary to tertiary syphilis in different patients is observed after different periods of time, but on average this period takes from three to seven years.

About late and gummous syphilis

Tertiary syphilis develops due to significant damage to all organs and systems of the body by treponemal infection. In most situations, the transition to late stage diseases is due to the fact that patients either did not receive treatment at all, or the therapy was incorrect or interrupted. As a result, untreated syphilis turned into a severe generalized form.

Late syphilis is extremely difficult. Patients experience disruption of the functioning of all internal organs, the nervous system and brain, heart and blood vessels. When the nervous system is damaged, an extremely serious condition is observed, frequent headaches and clouding of consciousness, which indicates the transition of the disease to neurosyphilis.

When internal organs are affected, doctors diagnose visceral syphilis, when all the digestive, respiratory, and cardiovascular system organs are involved in the process. An extremely severe complication of the disease are gummous and tuberculate formations, which can be located not only on the skin, but also in all organs, bones and joints, and are inflamed nodes with progressive decay in the tissues. This form of the disease is called gummous syphilide, or gumma in tertiary syphilis. That is why late syphilis is extremely severe and in more than 34% of cases leads to the death of patients due to severe pathology of internal organs.

How to treat cutaneous syphilis and where to go

Syphilis is one of the most severe and dangerous diseases, therefore, if treponemal infections are suspected, it is extremely important to as soon as possible contact a specialized medical institution for testing. If you don’t know which doctor to trust, the Venereology Guide is ready to help you choose an experienced venereologist in your city.

Only by identifying the symptoms of the disease in time and receiving the results of all diagnostic tests can you be confident in the quality of the therapy you receive.

Contact the “Venereology Guide” and you are guaranteed to appreciate the European quality of services provided in the field of modern venereology.

Syphilis is a severe systemic infection transmitted through sexual contact, household contact or blood transfusion. By and large, the causative agent of the disease, the microorganism Treponema pallidum, is quite sensitive to quite standard antibacterial drugs from the group of penicillins and tetracyclines.

The main thing is to strictly observe the dosage and duration of use. However, in the absence of therapy, there is a high risk of the pathology becoming chronic, relapsing. A rash with syphilis occurs already at the secondary stage of the process, so such a sign is a serious reason for contacting a venereologist as soon as possible.

Unlike most dermatoses, rashes caused by Treponema pallidum are characterized by a number of signs:

• there is no specific localization of lesions of the epidermal cover, the only exception is chancre specific for primary syphilis, which forms at the site of penetration of treponemes into the skin or mucous membranes;
• there is no predisposition to the merging of rash foci; as a rule, the foci have a clearly defined border, although their shape may be different;
• with a long course of the disease, a rash can appear on the body for no apparent reason and also disappear spontaneously without any treatment;
• none additional symptoms, syphilitic rashes are not characterized by itching, peeling, general health remains within normal limits, with rare exceptions, after the disappearance of the rash, no traces appear on the skin;
• the shade of the lesions varies from pale flesh-colored at the initial stage to red-brown to black;
• the simultaneous presence of several types of rash (for example, spots and papules);
• rapid disappearance when selecting an appropriate course of therapy.

It is worth noting

A person with a similar clinical picture of pathology is extremely contagious.

In addition, the skin manifestations of syphilis are characterized by a clear periodicity. The disease begins with an incubation period. Its duration varies depending on various patients from 2-3 weeks to several months. Pathology manifests itself with the appearance of hard chancre. Often there are systemic manifestations(temperature, deterioration of general condition, etc.). And only then, after a few more weeks, a syphilis rash appears. It persists (including periods of remission and exacerbation) until the disease is completely cured.

It is worth noting

Approximately from the moment of infection to the appearance of lesions on the body, up to 10-15 weeks pass. However, in some cases (for example, when treponemas enter the body through a blood transfusion from a patient), rashes appear earlier.

A person does not immediately learn about infection with syphilis, since the disease begins with an incubation period. Its duration depends on the state of the immune system, the presence concomitant diseases, parallel use of antibiotics (standard dosages for the treatment of the vast majority bacterial infections not fully effective against treponema). The primary form of syphilis is characterized by the appearance of so-called chancre. Externally, it looks like a round ulcer surrounded by a raised ridge.

The inner surface is flat and smooth. However, such skin lesions are painless; when rubbed with clothing or pressure, ichor may be released. Typically, chancre forms on an area of ​​the body that has been in direct contact with infected secretions. Usually these are the genitals, during medical procedures or after unprotected oral sex - the mucous membrane of the nasopharynx. Less commonly, a similar sign of syphilis forms on the abdomen and inner thighs. In such cases, the size of the chancre can be up to 40-50 mm or more.

Most often, erosive damage to the body is single, but sometimes multiple ulcerations may occur. A rare atypical form of primary syphilis is chancre - felon. Its distinctive feature is its localization, which is atypical for this disease - on the palms and fingers. In this case, in addition to the ulcer, swelling, local hyperthermia, and redness are observed.

In most patients, by the beginning of the secondary period of syphilis, the chancre heals even without the use of any external or oral medications. However, this stage is characterized by the appearance various kinds rashes. Previously, the pathogenesis of such a course of syphilis was associated with the activity of the treponemes themselves. But in the course clinical trials Scientists have found that the main physiological reason for the formation of certain symptoms that reflect the stages of pathology is the body’s response.

That is why the timing of different periods of syphilis, its external manifestations, and the alternation of exacerbation and remission differ for different patients. During the initial introduction of treponemes, the human immune system reacts by forming a dense infiltrate. Then, under the influence of ever-increasing changes (according to the mechanism of development, they resemble an allergic reaction), the nature and appearance of the skin lesion changes. The final result of the pathological process is gumma, specific for tertiary syphilis, with skin necrosis.

Syphilitic roseola

In appearance, such a formation is a spot that is no different from the surrounding skin except for color. The shade can vary from pale flesh or slightly yellowish to bright red. However, in the vast majority of cases, syphilitic roseola does not have a very contrasting color.

It is worth noting

The shade of the spots sometimes differs in the same person.

The shape of the rash is variable: the spots can be round or have unclear boundaries. They are located at a distance from each other and do not merge together. The size of each individual lesion ranges from a few millimeters to one and a half centimeters. There is no itching, peeling, or inflammation of surrounding tissues.

In the cold, roseola spots become more distinct; the same symptoms are noted at the beginning of therapy penicillin antibiotics. When pressed, the rash disappears, but after some time it returns again. Distinctive property A similar syndrome is caused by the acquisition of a more intense color when injecting a solution of vitamin PP.

Papular syphilide

This form of the disease is characterized by the appearance of various dense papules. On the body they can be located separately from each other or in small groups. The rash itself does not cause any discomfort, but when pressed, acute painful sensations occur. As a rule, papules remain on the body for up to 2 months, after which peeling occurs, then the rashes disappear. In their place, areas of pigmentation remain for some time.

The following forms of papular syphilide are distinguished:

• Lenticular, appears most often; outwardly, a similar rash resembles small nodular formations, up to half a centimeter in size. At the initial stage, the outside of the papule is smooth, and then becomes covered with transparent scales. The occurrence of such manifestations of secondary syphilis on the face is often accompanied by seborrhea, so the papules are covered with a denser coating. With a recurrent course, lenticular papular syphilide characterized by the merging of rashes into groups of different shapes - semicircle, arc ring, etc.
• Miliartny, with this form of syphilis, papules do not exceed a few millimeters; they form only around hair follicles(including vellus) or ducts sebaceous glands. The consistency of the formations is quite dense, sometimes covered with a horny coating. As a rule, miliary syphilide is localized on the arms and legs. Such formations can be accompanied by itching, tend to last a long time, and do not respond well to standard therapy.
• Coin-shaped, is different large size papules (up to 2.5 cm) of a fairly characteristic color (from dark brown to violet-red). Usually there are relatively few rashes, in addition, this form of syphilide is prone to combination with other types of rashes. Often the lesion resembles fireworks - several small ones are located around a large spot (a similar phenomenon is called blasting or corymbiform syphilide). After the disappearance of the coin-shaped papule, areas of disturbed pigmentation remain. Often such formations are localized in the area inguinal folds, between the buttocks. In this case, they are often damaged, become wet, and are constantly subject to erosion.

Sometimes so-called palmar and plantar syphilide is formed. In appearance they can resemble calluses or subcutaneous hematomas, which seem to “shine through” the epidermal cover.

Pustular syphilide

This form of the disease occurs with the formation of exudate-filled vesicles of various sizes and locations. According to experts, it occurs very rarely, in a maximum of 10 patients out of 100, and is more typical for patients with a weakened immune system, against the background of alcohol and drug abuse. This rash is often accompanied by a high fever.

Depending on the external manifestations, the following forms of pustular syphilide are distinguished:

• Acne. It manifests itself in the form of a small compaction, in the middle of which an accumulation of pus quickly appears. They are usually brightly colored and, as a rule, localized in the area where the sebaceous glands are located (on the face, back, hair growth area on the head).
• Smallpox. Characterized by rapid disintegration of the pustule into a surrounded inflammatory skin papulu. Subsequently, it becomes covered with a dense keratinized crust, which soon falls off, leaving a small depression. The rashes are not prone to merging, they look like chickenpox, so for differential diagnosis a number of studies are required.
• Impetiginous. At the initial stage, a characteristic pustule appears, which gradually collapses in the central part, forming a fairly large abscess. The rash has a bright red color; after the abscess ruptures, a yellowish or brown dense crust forms.
• Ecthyma. Characterized by the depth of the process, the pathology covers not only the epidermis, but also the dermis. It is large in size (up to 10 cm), often covered with a thick crust. Soon it falls away, revealing an ulcerative surface limited by raised skin. After healing, a scar forms at the site of ecthyma.

Another type of pustular syphilide is rupiah. It is prone to a long course and complex healing processes, in which drying crusts are layered on top of each other, forming something like a shell rising above the surface of the skin.

Syphilide herpetiformis

In terms of external manifestations it is very similar to pustular syphilis, but in terms of pathogenetic changes it is more similar to the symptoms of tertiary syphilis. Serves as a sign severe course pathology, usually occurs in weakened patients prone to immunodeficiency, excessive alcohol consumption, drug addiction, against the background of untreated syphilis. In appearance (this is very noticeable in the photo), syphilide herpetiformis is plaques (their size varies from 1 to 6 cm) of bright color. They are covered with small blisters on top, which looks very similar to herpes. However, after a few days they burst, and the pustules are covered with small ulcers on top.

Pigmentary syphilide

This form of the disease is also called leukoderma. Typically, its manifestations occur six months after infection. Pigmentary syphilide is localized in the neck, so it is often called the necklace of Venus. At first, foci of increased pigmentation with uneven outlines appear on the skin, then they lighten. They are not prone to changing size and merging; they are more often formed in women; as a rule, they are difficult to treat. Often, such pigmentation disorders are accompanied by the penetration of pathogens into the cerebrospinal fluid.

Skin manifestations of the late period of the disease

Tertiary syphilis occurs against a background of long-term inflammatory processes in the epidermis and dermis. One of the manifestations of the late period of the disease is gumma - a neoplasm quite dense in consistency, its size can reach a walnut. There is no pain when pressed.

Gumma is formed in the epidermis, so it moves easily under the skin, usually forms on the legs, can be single or merge together. After some time, from the middle of the formation stands out tissue fluid. Gradually the gap grows, which leads to the formation of ulceration combined with necrosis.

Such lesions can remain on the skin for a long time (sometimes up to several years). After healing, a scar or depression may form on the skin. Tuberous syphilide is another manifestation of tertiary syphilis.

Accompanied by the formation of specific formations collected in groups bluish tint. Depending on the individual characteristics of the patient, they may dissolve or develop into ulcers with subsequent scarring.

Clinical picture of congenital syphilis

An infant infected with syphilis in utero has a high probability of death, especially if the pathology manifests early. If the disease develops in the first months after birth, symptoms typical of secondary syphilis occur. Congenital syphilitic roseola is characterized by peeling, the appearance of scales, and the appearance of a bright red hue. Papular syphilide in children occurs with thickening of the skin on the soles and palms, and buttocks. Then the surface of such a formation becomes shiny and begins to peel off greatly.

When symptoms of syphilis form in the mouth as a result of sucking and screaming, deep cracks appear, their healing is accompanied by the formation of scars. If such rashes are in the nose, a runny nose occurs. In some cases, there is a risk of complete destruction of the nasal septum.

It is worth noting

If syphilis appears at a later age, its manifestations are no different from the course of the secondary form of infection in adults.

Syphilitic rash: are there differences in the course of men and women, methods of diagnosis and therapy

Many manifestations of secondary syphilis do not differ in either men or women. However, representatives of the fairer sex are more likely to form leucoderma (“Venus necklace”). In addition, there is a certain difference in the localization of acne-like pustular syphilide, since in men the secretory activity of the sebaceous glands is increased. There are quite definite differences in the location of lesions in the genital area.

In men initial manifestations pathologies (chancre) are located on the head of the penis, in women - on the mucous membranes of the genitals. In addition, infection in the fairer sex is dangerous in terms of the risk of pregnancy against the background of an active course. infectious process. In case of intrauterine infection of a developing fetus, the risk of death of the child is high; a similar probability remains in the postpartum period.

It is worth noting

As a rule, skin manifestations of a syphilitic infection are not accompanied by severe itching. It appears extremely rarely and only during the period of healing or scarring.

Some symptoms of Treponema pallidum are quite specific, but treatment is not started without confirming the diagnosis. Syphilitic rash should be differentiated from other dermatoses.

This is possible using microscopy of the discharge and specific immunoenzyme methods, hemagglutination reactions, Wasserman. They may give unreliable results initial stages diseases, however, when skin manifestations occur, such techniques are very specific.

Syphilitic rash is quite treatable, but the main condition is timely appeal to the doctor. The doctor prescribes a long course of antibiotics from the group of tetracyclines, penicillins, and macrolides. In some cases, antihistamines are indicated. Anti-inflammatory external ointments and gels are sometimes used. However, you should not try to cope with the infection on your own; treatment of syphilis requires a professional approach.