Increasingly, specialists in dermatology and venereology are paying attention to the fact that syphilis is much more widespread in society than official statistics show. Among the many reasons for this phenomenon is the fact that patients with primary signs of the disease rarely go directly to a specialist. It happens that the signs of syphilis are detected during a routine examination by therapists, dermatologists and even cosmetologists. estet-portal.com recalls that it is extremely important, if syphilis is suspected, to convince the patient of the need for immediate specific treatment, since the early period is most favorable for therapy.
Typical signs of syphilis to be aware of when examining
All doctors know that a hard chancre is considered a diagnostic sign of syphilis. But, with the exception of venereologists, not all specialists clearly understand what this symptom looks like. Translated from the old French language, chancre means a painless sore. At the site of introduction of the causative agent of syphilis into the skin or mucous membrane, a rounded erythema is formed about 1.5 cm in diameter, but sometimes less. Erythema has clearly defined edges that do not protrude above the skin. After a few days, it turns into a papule, which peels off a little. Then erosion or sometimes a sore is formed on its surface. If you grab an element with two fingers, slightly lift it and squeeze it, a seal is felt on the basis of erosion.
Erythema and erosion in the primary period of syphilis do not cause subjective sensations in the patient, so such symptoms are usually diagnosed by chance.
Erosive chancre rapidly epithelializes. In its place is a pigment spot, which soon disappears. A dense infiltrate at the base of the erosion persists for several weeks, then completely resolves.
A deeper skin defect is less common – ulcerative chancre. It develops in patients weakened by other infections and diseases, and can also occur when a secondary infection is attached, when erosive elements become inflamed. Ulcers can vary in size – from a pinhead to a 5 kopeck coin, and the compaction at the base is more pronounced than that of erosions. They are also painless, but heal with the formation of a round, even, hypochromic scar.
The number of chancres can vary from fifty to a single element. Their typical localization – in the genital area. However, signs of syphilis in the form of erosive elements can be found on the nose and cheeks, on the lips, in the mouth (affecting the tongue, gums, soft palate), on the abdomen and inner thighs.
The initial period takes about 6-8 weeks, and the start of specific treatment during this period has the most favorable prognosis, since the syphilitic lesion is limited to the skin and mucous membranes, and the internal organs have not yet suffered from the organic changes associated with this disease.
Some manifestations of atypical signs of syphilis that are useful to know
Syphilis can manifest itself as a panaritium on the hands, this often happens in medical workers. On the terminal phalanges of the thumb and forefinger, the skin thickens and erosions form. The finger hurts a lot, swells and becomes purple-red with a bluish tint. The infiltrate captures all tissues up to the periosteum. The chancre takes the form of a deep ulcer with jagged edges and a purulent coating.
Diagnosis of syphilis is made difficult by compaction of the entire phalanx of the finger, and not just the base of the ulcer, which makes it similar to dactylitis of another etiology.
Ulcers on the finger do not heal for several weeks, similar to vulgar felon. However, there are also features of the course of the disease:
• shooting sharp pain in the finger,
• an increase in the elbow and axillary lymph nodes.
Another atypical manifestation of syphilis that a doctor should be aware of – amygdalitis, when the pharyngeal tonsil turns red, increases in size and thickens. The patient complains of pain when swallowing, voice change. Outwardly, neither erosions nor ulcers are visible on the tonsils. The condition is accompanied by fever, headache and general weakness. Feature of amygdalitis in syphilis – unilateral enlargement of the lymph nodes in the neck and under the lower jaw. They are painless, mobile and have a compacted consistency.
See also: Approaches to the treatment of sexually transmitted infections
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