Roseola - symptoms in children and adults (high temperature, spots on the skin), diagnosis and treatment. Differences between roseola and rubella. Photo of a rash on the body of a child. Syphilitic Roseola - A Symptom of a Terrible Disease Pink lichen or syphilitic roseola ka

Syphilis is not only a sexually transmitted infection, transmission from mother to child during childbirth is not ruled out. But this is just the disease that will be dangerous for its consequences and complications. Therefore, it is important to take timely action.

Symptoms of syphilitic roseola

There are three stages in the clinical course of syphilis. The first is characterized by the formation of a hard chancre at the site of the introduction of the pathogen - this is an ulcer that has a dense and hard base, passing on its own, for about a month.

After 5 - 8 weeks from the moment of formation of the chancre, a generalized rash appears. This will be syphilitic roseola - secondary syphilis. These are pink, and later paler rashes with blurry outlines and a smooth surface, no more than one centimeter in diameter. The rash grows in waves, several dozen elements every day. Long-standing syphilitic roseola becomes yellow-brown in color. The location of the rash is erratic, on the whole body, but does not affect the face, hands and feet.

In addition to fresh, there is also recurrent syphilitic roseola. In this case, the spots are localized in separate areas of the skin and are less pronounced. For this type of rash, larger sizes are characteristic, and the color is more bluish.

In addition to the typical forms of syphilitic roseola, there are also atypical ones:

scaly roseola, manifested by typical skin scales that are similar to crumpled papyrus paper;
lifting roseola - rises above the surface of the skin and resembles blisters, there are no unpleasant sensations.

The third stage, in the absence of treatment, can make itself felt after a few years. The entire nervous system, bone tissue, and internal organs are affected. When infected with syphilis during pregnancy, with a high percentage of probability, the born baby will have a congenital form of syphilis.

Syphilitic roseola is not dangerous, but is a sign of a serious illness that should not be ignored. It is important to diagnose it in time and take measures, because it is possible to completely cure syphilis only at its first stage, the second and third are translated only into deep remission.

Treatment of syphilitic roseola

Treatment is carried out only under the supervision of a venereologist. The scheme is developed after the correct diagnosis is made, with additional research methods. Self-treatment of syphilis is unacceptable, the effect will be absent, and the pathology will continue to develop, affecting new organ systems, which is why the likelihood of a favorable outcome is practically absent.

The treatment period is long, and depends on many parameters: the primary process is treated for a couple of weeks, and with the formation of syphilitic roseola, for several years. Individual treatment takes place under the supervision of venereologists, at home or in a hospital. Treatment is based on antibiotic therapy, the most effective are antibiotics of the penicillin group.

Syphilis is a curable pathology, but it is important to start therapy immediately, the earlier the diagnosis was made, the more successful and adequate the treatment will be.

The main problem in treatment is untimely treatment, and there is an explanation for this. With the appearance of syphilitic roseola, patients study the photo, and can "set" the wrong diagnosis - an allergic reaction, which is why there is no timely treatment and the outcome of treatment will be unfavorable.

Syphilis is a fairly serious disease that affects not only the skin, but also the internal organs in the advanced course of the disease and the lack of timely treatment.

What is the rash with syphilis?

syphilitic rash in the photo

Rashes with syphilis almost always occur in the second stage of this disease, and in appearance they are very similar to ordinary allergies, or. But it is with syphilis that the rash on the patient's body differs in some characteristic features, in the event of which an urgent appeal to a competent specialist is required.

The rash looks like small pink patches that are localized on the skin in the thighs, upper arms or shoulders. But it is also possible the occurrence of spots on other areas of the skin of the body.

The rash is one of the main symptoms of syphilis, but it remains on the skin for no more than two months, after which it simply disappears. Many patients do not complete the course of prescribed therapy, as a result, the disease passes into a more severe stage, in which blood and lymph infection occurs.

It is very important to establish the correct diagnosis in time and conduct a timely course of treatment, since it is easier to eliminate any disease at the initial stages of its development. And syphilis is no exception, since with its early detection, it is treated quite simply. But if you start the disease, then serious and dangerous complications can develop. Indeed, under such circumstances, there is a risk that drug therapy will no longer give the expected effect, as a result, the treatment will be unsuccessful and useless.

Stages of the disease

There are several stages that patients with syphilis go through:

At the primary stage, about a month after infection, a characteristic rash appears on the patient's body, which turns red in some places, forming small ulcers. After a few days, the spots may disappear, but then they will definitely reappear, since this disease does not go away on its own. A hard chancre also occurs. Very often, a syphilitic rash that occurs on the face is confused with ordinary acne or acne.
At the next stage of syphilis, which is called secondary, the rashes become pale pink and bulging, interspersed with bluish pustules. With secondary syphilis, the patient becomes dangerous to others, since he is already a carrier of the infection and can infect someone.
The third stage of the disease is a neglected course of the disease, in which pathogenic microorganisms penetrate the body, affecting tissues and organs.

A competent and highly qualified specialist can easily distinguish a syphilitic rash from all other inflammatory elements on the skin of the body.

Signs of a syphilitic rash

in the photo the first signs of a syphilitic rash on the abdomen

With the disease under consideration, the spots on the patient's body differ in several characteristic features, among which the following can be distinguished:

Rashes, as a rule, are not localized on a specific area of the body, they can appear anywhere.
The affected areas do not itch, do not itch and do not hurt, there is no peeling on them.
The elements on the body are dense to the touch, round in shape, can be single or merge with each other.
A syphilitic rash may be pink or red with a blue tint.
After the disappearance of the rash, no traces 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.

Symptoms in men

In men, after infection with syphilis, a small ulcer appears on the genitals. It can occur on the penis itself, at the urethra, in the anus area. The ulcer is usually bright red with clear edges.

Syphilis is a systemic disease that affects not only the reproductive system or epidermis, but also internal organs, the nervous system, and even bones.

For men with this disease, it is characteristic that one stage successively replaces another, proceeding with all the symptoms inherent in each of them.

The place of formation of a hard chancre depends on how the infection with syphilis was carried out. Because it is most common in men
unprotected intercourse with an infected partner, then a hard chancre usually occurs on the genitals. But it can also form in the mouth when infected as a result of oral sex with a patient (with non-traditional male orientation), or when infected by household contact.

The formation of a hard chancre is preceded by the formation of a small spot on the skin or mucous membranes, which gradually grows and ulcerates as the pathogen penetrates deep into the skin.

It is possible to distinguish a syphilitic ulcer from another inflammatory element on the skin by some signs:

correct round shape;
has a red bottom;
there is no inflammation and redness of the skin around the ulcer;
there is no soreness with pressure, as well as itching sensations.

After a few weeks, the hard chancre goes away on its own, which does not mean at all that the disease has receded. All this indicates the onset of the secondary stage of syphilis and its transition to the chronic stage.

The main symptom of secondary syphilis in men is syphilis, or a skin rash that can be observed anywhere on the body, even on the palms and feet.

Symptoms of secondary syphilis in men:

general malaise, weakness;
headaches and joint pains;
a slight increase in body temperature;
enlargement of the lymph nodes.

The danger of this disease lies in the fact that during the transition to the chronic form or to the tertiary stage, it affects the internal organs and tissues, the nervous and skeletal systems, causing irreparable harm to human health. Moreover, for many years it may not make itself felt, and appear after a long period of time, when conventional treatment may simply be ineffective.

Soft chancre in men

In men, such a phenomenon as a soft chancre often occurs. The soft chancre is located in the same place as the hard one, it is distinguished by a bright red bloody color, it secretes pus abundantly. It differs from a hard chancre in that it has softer edges, and also causes discomfort and pain. A soft chancre, another name for which is chancroid, provokes inflammation of the lymph nodes, nausea and vomiting, weakness and dizziness may occur.

Chancroid is also a symptom of syphilis, and due to its peculiar features, it is called a venereal ulcer.

Unlike hard chancre, the causative agent of which is pale treponema, the occurrence of chancroid provokes a microorganism such as streptobacillus or soft chancre bacillus. The incubation period for this infection is approximately ten days, after which the soft chancre bacillus begins its active reproduction and spread throughout the body of the carrier.

The ulcer, formed as a result of the activity of the bacterium, has uneven edges and, when pressed, releases a lot of purulent fluid. In the absence of timely and proper treatment, this epidermal lesion deepens and expands, as a result of which the infection penetrates into the deeper layers of the skin.

Differences between hard and soft chancre:

A hard one does not cause soreness and inflammation of the skin around it, does not ooze with pus or blood, unlike a soft one, in which there may be small inflammatory elements, redness or a rash around the ulcer.
A soft chancre does not have a solid base, the skin around it can peel off and become inflamed, often ulcers occur, which subsequently merge with the main focus of inflammation.

Symptoms in women

in the photo, the manifestation of syphilis in women on the lips

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 lengthened due to various factors, such as taking antibiotics.

Primary syphilis in women is characterized by the following symptoms:

In the area through which the causative agent of the disease entered the body, at the end of the incubation period, a hard chancre is formed. It can be the genitals, the anus or the oral mucosa. After about fourteen or fifteen days, there is an increase in the lymph nodes located next to the ulcer, which disappears on its own a month after the onset.
An ulcer usually does not cause any discomfort and pain, but signs such as decreased performance, weakness, and a slight rash on the body may be noted.

Signs of secondary syphilis:

elevated temperature;
pain in the head;
soreness and aches in the joints;
spotty rash on the body, the elements of which subsequently become convex and turn into sores;
many women lose their hair on their heads.

In the absence of therapy, the tertiary stage develops, which is very dangerous due to the likelihood of complications and the penetration of the pathogen into the body. The danger of tertiary syphilis lies in the fact that syphilides affect the internal organs, as a result of which the patient may be fatal. There is also damage to the nervous and skeletal systems.

Soft chancre in women

Chancroid or soft chancre is a sexually transmitted disease that, unlike syphilis, is transmitted only through sexual contact. An ulcer that occurs on the genitals usually causes unpleasant pain.

In women, the incubation period for this disease is longer than in men. Chancre formation occurs on the labia, in the clitoris and vagina. Features of soft chancre:

the ulcer is softer to the touch than with a hard chancre;
there is a release of pus and blood;
the area around the soft chancre becomes inflamed.

Very often, due to the ingress of pus on healthy skin, a secondary chancre occurs. Women are characterized by the appearance of many bubonic ulcers, located near the inflamed lymph nodes, which subsequently open up and leave behind deep scars. A soft chancre in women looks the same as in men.

Syphilitic roseola

Spotted syphilides are external signs of syphilis, which are also called syphilitic roseola. The appearance of such spots, characteristic of the secondary stage of the disease, usually occurs along with the appearance of a syphilitic rash.

Symptoms of syphilitic roseola:

Spots of pink color, not distinguished by relief.
Roseolas are not flaky.
Do not provoke discomfort, itching or burning.
The shape of the spots is wrong.
Before the formation of roseol on the skin, the patient has a fever, there are pains in the head and joints.
Over time, the color of the rash changes from pink to red, then they gradually turn yellow and disappear.

Syphilitic roseolas, as a rule, are isolated from each other, and they can merge only if there are a lot of rashes.

Venus Necklace

Another manifestation of the sexually transmitted sexually transmitted disease in question is the so-called necklace of Venus. We are talking about white spots localized on the skin of the neck and shoulders. These spots usually appear months after the infection with syphilis has occurred.

The beautiful and mysterious name of this phenomenon comes from mythology.

Round and white spots are usually preceded by hyperpigmentation of the skin in this area, which subsequently brightens, creating the appearance of lace on the neck. White spots are small in size, but they can merge with each other, and depending on this fact, syphilitic manifestations are divided into:

Spotted, which are isolated from each other.
Reticulated, partially merging.
Marble is called completely merged spots with syphilis.

In addition to the neck, the Venus necklace can appear on the skin of the chest or abdomen, as well as the lower back or back. The Venus necklace, which arose in an atypical place, is often confused with other skin diseases, for example, with or.

It is noteworthy that the causative agents of syphilis, microorganisms called pale treponemas, are never found in white syphilitic skin lesions. In medicine, there is an assumption related to the fact that Venus spots appear on the skin due to damage to the nervous system, which leads to pigmentation disorders.

But it has not yet been established why white spots appear only on the skin of the neck, and in very rare cases on other parts of the body, and also why it affects women who have contracted syphilis more often than men. The necklace of Venus occurs in secondary recurrent syphilis.

Acne with syphilis

Peculiar rashes on the face or acne often become one of the symptoms of body damage with pale treponema. Very often, these symptoms of syphilis on the face are mistaken for an allergic rash, as a result of which the correct treatment is not carried out. All this leads to the fact that syphilis takes a chronic form, and there is a risk of damage to the patient's nervous system.

At the initial stage of the disease, acne looks like red formations, which after seven days turn into ulcers. After opening them, the rash may disappear, but after a certain amount of time it will reappear.

With secondary syphilis, acne becomes purple with a bluish tint. In this period, the patient becomes very dangerous to others.

Tertiary syphilis is characterized by bumpy skin of the face, red with a blue tint, purulent elements merge with each other, forming extensive skin lesions. The result of such lesions are deep scars on the surface of the epidermis.

With syphilitic acne, the patient's body temperature often rises, and this condition requires mandatory medical treatment. In this situation, antibiotics cannot be dispensed with in order to prevent the transition of the disease to an advanced stage.

Syphilis on hand

A syphilitic rash, unfortunately, can appear on any part of the body, including the hands. In most cases, people do not pay attention to small spots, because they do not cause anxiety and discomfort. Their occurrence is often associated with allergies or dermatitis.

A syphilitic rash on the hands appears in the second stage of the disease, and most often affects the palms and elbows in the form of the following formations:

Roseolas that disappear after a certain amount of time to reappear on the skin. But their disappearance does not mean the retreat of the disease.
Small lumps on the skin that do not cause pain or discomfort.
Ulcers, which are a sign of neglect of syphilis.

Syphilis in children

Syphilis is transmitted to children during fetal development from a sick mother. The fetus becomes infected from about the fourth or fifth month of pregnancy, as a result, the child develops congenital syphilis. The disease, as a rule, makes itself felt already during the first three months of a baby's life. The following pathological changes occur in the child's body:

Damage to the central nervous system.
Soft gummas are formed in the tubular bones.
Syphilitic meningitis develops.
Hydrocephalus.
Paralysis.

For children from one year is typical:

Development of cerebral ischemia.
Convulsive attacks.
Strabismus.

Signs of childhood congenital syphilis that appear from the age of four:

Keratitis.
Labyrinthitis.
Buttock-shaped skull and other severe pathologies.

If untreated, the death of the child occurs within a few months. In the attached picture below, you can see syphilitic pemphigus in newborns.

Transmission routes

Syphilis is one of the most common sexually transmitted diseases, ranking third in prevalence worldwide. In order to avoid contracting this infection, you need to know how it is transmitted and how it manifests itself.

The main ways of infection with syphilis:

Sexual way - infection is the result of unprotected intercourse, it can be with traditional sexual intercourse, as well as with anal and oral sex. This is explained by the fact that pale treponema, which is the causative agent of syphilis, is contained in male sperm and in female secretions.
The household route of infection is the rarest, since pathogenic microorganisms outside the human body die almost immediately. But if the patient has open chancres or abscesses, the infection can get on household items. Then, in the absence of hygiene rules, for example, when using one towel, a healthy person is infected by microbes entering microcracks or wounds on the skin, as well as on mucous membranes. Very often, infection occurs through a kiss.
Transmission of the disease is also possible through blood, for example, through transfusion. Or as a result of using one injection syringe among several people. Syphilis is a common disease among drug addicts.
Infection of the fetus in the process of intrauterine development from a sick mother. This is fraught with very serious complications for children, who in most cases are born dead or die during the first months of life. If intrauterine infection of the baby can be avoided, then it remains possible through mother's milk. Therefore, such children are shown feeding on artificial mixtures.

How to recognize

It is very important to know exactly how this terrible disease manifests itself, so that when the first symptoms occur, timely treatment can be carried out.

The first signs of syphilis appear within two weeks after infection.

If you do not pay attention to them, then you can bring the situation to irreversible consequences, when drug treatment becomes ineffective. And the result of untreated syphilis is death.

The main symptoms of syphilis:

Painless ulcer located in the genital area.
Enlarged lymph nodes.
Eruptions on various parts of the body.
Increase in body temperature.
Deterioration of well-being.
In the later stages, paralysis, mental disorders and other severe abnormalities.

Treatment of syphilis

This disease can be treated only after consultation with a specialist dermatovenereologist, who will prescribe all the necessary diagnostic measures and adequate appropriate treatment.

It is unacceptable to independently make a decision on taking medications, as well as the use of funds from traditional medicine. Treatment of syphilitic lesions of the human body is a rather lengthy process in which it is necessary to take medication continuously for several months. And in the later stages of the disease, therapy can last several years.

Pale treponema is very sensitive to antibiotics of the penicillin series, which is why they are prescribed to all syphilitic patients. If these drugs are ineffective, they are replaced by tetracyclines, fluoroquinolones or macrolides.

Most often, the treatment of syphilis occurs in a hospital, where every three hours the patient is injected with penicillin for several weeks. The patient is also prescribed vitamin substances that help strengthen and restore immunity, which suffers during long-term antibiotic treatment.

Among the medicines that are prescribed to patients with syphilis, the following can be noted:

Bicillin, Ampicillin, Retarpen, Azlocillin, Ticarcillin, Extencillin.
Medicamicin, Clarithromycin, Ciprofloxacin, Ceftriaxone, Doxycycline.
Miramistin, Doxilan, Bioquinol, Bismoverol.

Therapy of syphilis can be considered successful only if the disease does not recur for five years. It is very important to follow all the doctor's prescriptions, as well as to completely exclude sexual intercourse for the duration of medication treatment. It is very important to follow preventive measures, avoid casual sex, do not neglect personal hygiene and a barrier method of contraception. A patient with syphilis should have his own separate dishes, towel, razor and other accessories.

To confirm the syphilitic cause of the disease, additional studies are carried out:

Leukoderma

When treponema spreads through the bloodstream, the body begins to fight the infection and produces antibodies. During the interaction of the microbe and the immune system, biologically active substances are released, leading to the development of manifestations of secondary syphilis. One of these signs is a syphilitic rash.

How to determine what caused skin changes? When rashes of unknown origin appear, you should consult a dermatologist. In many cases, the diagnosis becomes clear on examination.

Lenticular appears both with fresh secondary syphilis and with its relapses. The rash looks like a nodule up to 5 mm in diameter with a flat top, up to 2 mm high, red. The surface is initially smooth, then begins to peel off. With fresh syphilis, such formations are often located on the forehead ("crown of Venus"). The rash takes about 2 weeks to develop. The focus may consist of a large number of such tubercles.

For ulcers and gummas, you can use synthomycin emulsion, Levomekol ointment, powder with talc. It is not necessary to treat the surrounding skin with antiseptics.

Papules do not occur on the dorsum of the hands. Most often they are located on the back, the back of the head, in the forehead and around the mouth.

A hard chancre can be located on the lips or on the tongue. In the latter case, a slit-like or stellate form of the defect occurs.

The lesions do not protrude above the level of the skin and do not increase in size (however, they do not decrease either);

small spots (tertiary Fournier roseola).

Skin manifestations accompany the congenital form of the disease.

The most common localization that can be traced by studying the photo is the limbs, but it rarely appears on the face or hands.

In addition to the most common - typical syphilitic roseola, a scaly or elevating form of the disease can also be observed. The rashes themselves are not dangerous, but require urgent medical attention.

A large number of elements appear after the completion of the primary period. This period is about 10 weeks after infection or 1.5-2 months after the onset of hard chancre. Small bright spots or seals appear, arranged symmetrically. With relapses of the disease, syphilides occur in much smaller numbers, are located on a limited area of \u200b\u200bthe skin, are grouped into rings or garlands.

all skin manifestations of secondary syphilis are highly contagious.

How does the rash appear with syphilis in the late phase:

white patches (leukoderma).

Perhaps they constitute the transition stage of spotty syphilis to papular. In relatively rare cases, with a very abundant rash, individual spots crowd closely together in places. And they begin to come into contact with each other: the so-called confluent roseola is formed - roseola confluens.

Herpetiform syphilis

Antihistamines, such as Claritin, are often prescribed to prevent an allergic reaction to antibiotics.

Sometimes the ulcer does not form, and the gumma heals with the formation of a subcutaneous scar. The skin over it is retracted. Also gumma can be calcified. The knot becomes very dense, shrinks slightly, and persists indefinitely.

the rash can be of different shapes and colors, which is due to the presence of different elements at the same time (papules, pustules, and so on), as well as rashes of the same type at different stages of development; these are true and false polymorphism, respectively;
treponemal tests (immunofluorescence reaction, treponema immobilization reaction);

The first symptoms of a syphilitic rash appear at the end of the incubation period, which on average lasts from 2 weeks to 2 months. A defect with a diameter of 2 mm to 2 cm or more appears on the skin or mucous membrane. The primary lesion is called a "hard chancre" and looks like a rounded ulcer with even edges and a smooth bottom, often saucer-shaped.

The surface of the rashes is smooth, but they themselves do not merge with each other;
The outlines of the spots are unclear, the size is up to 1 cm;

Impetiginous syphilis

Roseolous rash is registered in 75% of patients. It is represented by small rounded or oval spots with uneven, as if torn outlines. Elements often have a faded pink color, sometimes they are any shade of red - from pale pink to deep crimson. In the same patient, the color of the rashes may be different. When pressed, the roseola disappears. Outwardly, it resembles small splashes of paint.

Small-spotted syphilides develop in the form of bright red or pale red spots, sharply demarcated from the surrounding skin. There are round or oval outlines. The size of a pinhead with a fresh rash, to the nail of the little finger with relapses. Do not rise or slightly rise above the skin. In the latter cases, it is called roseola elevata s. urticate and is observed in fresh, profuse rashes or becomes such after the start of vigorous specific treatment. As a rule, roseola does not cause subjective sensations. Fresh small-spotted syphilides pour out in large quantities.

Roseola with syphilis: symptoms

Histologically, with ordinary syphilitic roseola occurs

How to treat a syphilitic rash?

And since only temporary, unstable changes are observed in the skin proper, roseola disappears gradually without any persistent trace.

Syphilitic roseola, like other skin rashes that appear with syphilis, is evidence that the disease has passed into the secondary stage. If we talk about specific terms, then such a rash appears a few weeks later (from 5 to 8) after the onset of symptoms of the primary form of the disease - a hard chancre. If you are interested in what roseola syphilitic looks like, the photo will help you figure it out as accurately as possible, since there are a lot of diseases with similar symptoms.

When differentiating from erythema multiforme, one has to take into account the beginning of the latter in favorite places. Almost always on the extensor surfaces of the limbs, the bluish color of the elements, etc. You can mix roseola with it only in the initial period of its rash. Spots from the bite of flatheads are usually duller, grayish-blue and are located mainly on the pubis and lateral surfaces of the abdomen and at the armpits. Recognition can be difficult only with their abundant appearance. Marble skin differs from plum roseola by the development of a web with colored crossbars and pale loops. Elements of pink lichen form typical medallions and are accompanied by peeling.

Syphilitic ecthyma can form on the shins - a large (up to 2 cm) ulcer covered with a thick crust and surrounded by a purple corolla. With the growth of the formation and its gradual drying, a crust is formed in the form of a shell - a syphilitic rupee. Such an ulcer heals badly, a scar remains in its place.

detection of treponema in discharge from hard chancre or erosions;

This infiltration consists of plasma cells, lymphocytes and erythrocytes, gradually disintegrating. As a result, with long-standing roseola spots, under pressure, a slight brownish or even yellowish color may remain due to the presence of erythrocyte hemosiderin in the skin.

Papules are located separately from each other, but with constant friction with clothes or in the folds of the skin, they can merge. At the same time, they dissolve in the center, which leads to the formation of various figures. The surface of such rashes is smooth, shiny, color - from pale pink to bluish red and copper. When resolved, they are often covered with scales, leaving behind pigmentation. Sometimes papules ulcerate or enlarge, turning into wide condylomas.

It is associated with the reactivation of treponema in the focus of the disease. Such elements are usually not contagious. They have a tendency to spread peripherally.

pustules (papular-pustular rash);

In each phase of the disease, rashes with syphilis have their own characteristics.

Usually such a complaint is uncharacteristic. However, in recent years, there have been more and more cases of rashes accompanied by moderate itching.

Syphilitic roseola: symptoms

What is never observed with roseola. So it is difficult to mix them: only at the beginning of the rash, they may have some resemblance to roseola. With multi-colored lichen, the rash is not inflammatory, brown spots, flaky. When lubricating the elements of the rash with iodine tincture, the color becomes more intense - the signs are not characteristic of roseola.

Erosion is similar to an ulcer, but does not have well-defined edges. This is a superficial defect that can go unnoticed. A hard chancre or erosion is most often single, but several foci may form.

Spotted syphilis or syphilitic roseola(Roseola syphilitica). It is the most frequent manifestation of syphilis of the secondary period, observed both in the form of a fresh rash and in the form of relapses.

non-treponemal tests (microprecipitation reaction or rapid reaction with plasma);

In the late period of the congenital form of the disease, gummous and tubercular formations (syphilides) typical of the Tertiary period are found.

Primary syphilis

Recognition of a typical roseola is not particularly difficult in most cases. It appears suddenly, does not itch, does not peel off, has a number of characteristic accompanying signs of syphilis. That is, the remains of a hard chancre, primary adenitis or even polyadenitis. Blood reactions in this case, as a rule, are positive. In some atypical cases, roseola has to be differentiated from infectious erythema - typhoid, rubella, measles. In these cases, the general symptoms of these infections, the localization of the rashes, their nature, and persistent seroreaction should be taken into account.

What does the rash look like at different periods of syphilis: description and photo

Laboratory diagnosis of syphilis is quite difficult. It is difficult to interpret the results on your own, so you need to consult a doctor.

Small ulcers are more common in women and are located on mucous membranes. Giant chancres up to 5 cm in diameter are localized on the skin of the abdomen, inner thighs, perineum, chin, upper limbs (hands and forearms) and are recorded mainly in men.

enzyme immunoassay (passive hemagglutination reaction).

Does the rash itch with syphilis?

Tertiary syphilis

How to recognize a syphilitic rash?

With tubercular syphilis, limited dense, painless tubercles of a bluish-red color, up to 1 cm in size, form on the skin. They can ulcerate with the formation of deep defects with a steep edge, crusted and healed with the formation of a scar. There are such foci for several months.

Timely treatment of syphilis allows you to avoid the serious consequences of this disease, in particular, the formation of scars on the skin.

vesicles (vesicles);

Syphilitic leukoderma is usually observed in women in the neck, on the sides and back, forming the so-called necklace of Venus. Less commonly, it is observed on the body, on the legs or arms, in the armpits. Initially, spots with increased pigmentation of a yellowish tint appear. In the center of such foci, discoloration begins in the form of spots. They can merge to form a "lace" or "marble" pattern. No peeling or itching.

A papular rash is formed due to inflammatory impregnation of the upper layer of the skin and represents towering compacted foci. They have clear boundaries and are well demarcated from the surrounding skin. To the touch they are dense, hemispherical or pointed.

Syphilitic rashes, in order: syphilitic ecthyma, plantar syphilis, leukoderma

tubercles and gummas on the skin;

Syphilis is an infectious disease caused by the microorganism Treponema pallidum, or pale treponema. The pathogen enters the human body through damaged skin or mucous membranes. Transmission of the microorganism through the placenta and through blood transfusion is possible.

In some cases, with relapses, the spots form various outlines of the figure, for example, rings, garlands, a ring-shaped roseola is obtained - roseola annularis.

Miliary is located in the mouths of the hair follicles and is a nodule with a diameter of 1-2 mm. They have a round outline, dense, covered with scales, pale pink. Such elements are located on the body and on the outer surfaces of the limbs, where there are hairs. Sometimes they are accompanied by itching.

Read more about the ways of infection, diagnosis and treatment of syphilis in our previous article.

Gumma is a dense knot up to 3 cm in size, rising above the surface of the skin, painless. The skin over it gradually acquires a purple color. A typical location is a single lesion on the anterior surface of the lower leg.

Spots with secondary syphilis

Papular syphilide may be represented by skin infiltration. The skin thickens, reddens, swells, then peeling begins. This sign appears on the palms, soles, buttocks, as well as around the mouth and on the chin. The affected skin is damaged with the formation of diverging cracks. After their healing, scars remain for life. The nasal cavity and vocal cords are affected.

The most striking manifestation is papular syphilides, which have a different appearance:

The rash is not accompanied by pain or itching;

Syphilitic roseola: how to recognize

syphilitic pemphigus

Acne is represented by several small conical vesicles located on a compacted base. Bubbles are covered with crusts, which fall off after 2 weeks. Scars usually do not form.

In the future, the gumma may soften and open with the formation of a large ulcer. Its edges are dense, painless, steep, and the bottom is deep, covered with dead tissues. Such an ulcer exists for many months. After healing, a rough scar is formed, often acquiring a star-shaped outline.

Rashes with tertiary syphilis appear 3-5 years after infection. However, cases are described when skin manifestations occurred after 10-30 years. Often they are associated with improper treatment of the disease.

treatment leads to the rapid disappearance of rashes;

Without treatment, each element of roseola lasts an average of 2-3 weeks and then slowly disappears without a trace.

thickening of the walls of blood vessels,

Skin manifestations can be a sign of primary syphilis, when the microbe multiplies directly at the site of penetration. This forms a hard chancre.

If you carefully read the photo, but are still not sure that your rashes are associated with sexually transmitted diseases, pay attention to the following symptoms that accompany the rash:

The skin manifestation of primary syphilis is always accompanied by an increase in nearby lymph nodes.

congenital syphilis

What do rashes look like? In most patients with secondary syphilis, spots (roseola) form, less often small elevations (papules).

an itchy rash is uncharacteristic; elements gradually disappear, leaving no traces behind;

In 2-10% of patients there are formations in the form of vesicles (pustules). They are observed in debilitated patients and resemble acne, impetigo or other dermatoses. In differential diagnosis, it is important to consider that such formations are surrounded by a copper-red rim.

One of the atypical forms of primary syphilis is chancre-panaritium. It forms on the fingers. The affected phalanx swells strongly, turns red, becomes sharply painful. A deep ulcer of irregular shape is visible on the skin.

The ulcer is painless, the discharge from it is insignificant. It is located on a compacted area - an infiltrate. It is very dense and resembles thick cardboard, cartilage, rubber to the touch.

nodules (papules);

Secondary syphilis

In the focus of damage, treponema intensively multiply, so the primary chancre can serve as a source of infection for other people. The ulcer persists for about 7 weeks, after which it heals with a scar.

With mechanical pressure, the spots of the rash brighten, but very quickly restore their previous color;

Where does the rash appear in secondary syphilis? It can occur anywhere on the body. Despite the variety of symptoms, all secondary syphilides (skin manifestations) have common signs:

Roseola for syphilis

If you suspect syphilis, contact the author of this article, a venereologist in Moscow with 15 years of experience

Syphilitic ecthyma

and also there is a small round-cell infiltration around the vessels.

With elevated or urticarial roseola, in addition, there is a slight swelling and dilation of the lymphatic vessels. With granular roseola, the perivascular infiltrate is more pronounced. The epidermis above the roseola spots does not change. Therefore, roseola does not peel off.

For relapses of secondary syphilis, leukoderma is very characteristic. It appears six months after infection and persists for several months and even years, but sometimes disappears much faster. Interestingly, pale treponema is not found in the affected skin. This rash is resistant to treatment.

originality of color: at first bright pink, then turning into brownish and gradually turning pale; the rash may acquire a reddish, yellowish, pinkish tint;

The rash on the hands (palms) and soles is visible under the skin in the form of brown, gradually turning yellow spots with clear boundaries. Sometimes papules appear in the form of corns.

There are small and large-spotted syphilides.

proliferation of endothelial and adventitia cells,

In case of intolerance to penicillins, macrolides or tetracycline may be prescribed.

When roseola appears, it has a bright color - pinkish-red. Roseola that has existed for a long time changes its color and becomes light brownish. In some cases, sometimes on older elements of the rash, small papular elevations (roseola granulosa) can be seen in their central part.

How long does a syphilitic rash last in the secondary period?

Syphilitic roseola, if left untreated, tends to recur at various intervals. With fresh forms of syphilis (s. II recens), the number of eruptive elements is abundant and the rash is symmetrical.

limited vasodilation, predominantly superficial and less deep network of the skin itself,

A rare manifestation of severe secondary syphilis is syphilis herpetiformis, resembling herpes vesicles. It occurs in patients with alcoholism or severe concomitant diseases and indicates an unfavorable course of the disease.

Usually it persists for 1-2 months, gradually disappearing. With relapses, syphilides reappear. Under the influence of therapy, the rash quickly passes.

The spots are located separately from each other, do not merge and do not peel off. By consistency and relief, they do not differ from the surrounding skin. Their diameter ranges from 2 mm to 1.5 cm. They become more noticeable when the skin cools, for example, during an examination. Roseola without treatment lasts up to 3 weeks, is located on the back, chest, abdomen, less often on the forehead.

the skin around syphilides does not become inflamed and does not swell;

Tertiary, or late syphilis, occurs long after infection. It is accompanied by damage to the bones, nervous system and other organs. A rash with syphilis in the late period is one of the frequent manifestations of the disease.

elements of rashes do not spread along the periphery and do not merge, remaining limited;

First of all, it is necessary to prescribe antibiotics that destroy the pathogen. Penicillin preparations of different duration of action are used. Under the influence of medications, the rash disappears quite quickly.

Skin manifestations of syphilis

Syphilitic pemphigus is another typical manifestation of congenital syphilis. Bubbles with transparent contents, up to 2 cm in size, surrounded by a red rim, form on the skin. They usually appear on the palms and soles. Bubbles do not increase and do not merge. At the same time, the internal organs suffer, the general condition of the child worsens significantly.

A rash in secondary syphilis is a typical manifestation of the disease that occurs in most patients. The appearance of the rashes is different:

How long does a syphilitic rash appear?

There are certain diseases, and syphilis of the secondary period is also among them, which are difficult to diagnose due to the fact that manifestations can be characteristic of not one, but several diseases at once. It is enough to study the photos of rashes in patients with such a diagnosis available on the Internet and compare them in the photo, for example, with allergy symptoms, as it becomes clear why many people are in no hurry to seek medical help: they are simply sure that there is nothing dangerous for them roseola does not carry health, and therefore it is not necessary to take measures at all. It is important to remember that roseola with syphilis is already a signal that time has been lost: if at the first stage the disease is completely cured without leaving consequences, then the second can turn into irreversible disorders, and at the third stage only stabilization of the condition is possible, but not cure.

Recurrent roseola rash occurs 6 months to 3 years after infection. Very often it appears in the mouth, on the soft palate and tonsils. The rash has a red color with a bluish tinge, the elements are clearly visible against the background of a normal mucous membrane and resemble a sore throat. Sore throat, fever and other general manifestations are absent in most cases. At the same time, sores often appear in the oral cavity, on the walls of the larynx and vocal cords. This causes a hoarse voice.

For syphilitic roseola, the absence of peeling is characteristic, even with its reverse development.

With early congenital syphilis, which manifests itself soon after birth, typical secondary syphilides are often observed. However, this form of the disease is characterized by special skin manifestations.

Diagnosis and treatment

spots (roseola);
A coin-shaped papule is characteristic of a relapse of the disease. It is a hemispherical seal with a diameter of up to 2.5 cm or more. The color of the formation is bluish-red or brown. Papules are formed in small numbers, often grouped and combined with other skin manifestations. After their disappearance, pigmentation and a scar remain. If such a papule is located in an area with increased sweating (genitals, mammary glands, neck), it turns into a very contagious weeping syphilis.

They are located symmetrically on the lateral surfaces of the body and on the abdomen, they do not have negative localization. The rash may also occur on the palms and soles.

Impetiginous syphilis is formed by a seal - a papule, which suppurates in the center after a few days, forming a large layered crust. With the smallpox form, up to 20 papules up to 1 cm in size are formed, quickly shrinking into crusts. Such elements are stored for 1.5-2 months.

Leucoderma is observed mainly during relapses. It is resistant to treatment and can persist for a long time even after recovery. Such a lesion is often accompanied by specific changes in the cerebrospinal fluid.

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Syphilis occupies a special place among diseases transmitted mainly through sexual contact. One of the main causes of this disease is the promiscuity of sexual intercourse, while the syphilitic rash, the symptoms of which are pronounced, becomes a kind of “gift” received not for too diligent behavior. The peculiarity of the disease also lies in the fact that complete disposal of it is possible only in the initial stages of its course. The consequences become irreversible when the disease of the brain is affected, while treatment is already becoming almost impossible.

general description

The statement that syphilis is exclusively a sexually transmitted disease is not entirely true. The fact is that you can get infected with it in everyday life when the infection directly enters the bloodstream through scratches or wounds on the body, it 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 foci in the area of \u200b\u200bthe 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 the introduction of pale treponema, the causative agent of infection of this disease (which is mainly the genital organs), acquires signs indicating primary syphilis.

Symptoms of the primary stage

Signs of primary syphilis are the appearance of a small red spot that turns into a tubercle after a few days. The center of the tubercle is characterized by gradual tissue necrosis (its death), which eventually forms a painless ulcer, framed by hard edges, that is, a hard chancre. The duration of the primary period is about seven weeks, after the start of which, after about a week, all the lymph nodes undergo an increase.

Completion of the primary period is characterized by the formation of many pale treponema, 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.

Symptoms of the secondary stage

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

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

Lack of sensations of a subjective type (soreness, itching);
Dark red color of rashes;
Density;
Clarity and regularity of roundness or roundness of outlines without their tendency to possible merging;
Peeling of the surface is unexpressed (in most cases, its absence is noted);
Spontaneous disappearance of formations without subsequent atrophy and scarring stage is possible.

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

This manifestation of this stage of syphilis is the most frequent. Indicates its occurrence to the fact that the spread of pale treponema has occurred throughout the body. A characteristic manifestation in this case are roseola (spots) in a mild inflammatory form. Initially, the color is pale pink, the outlines of the rashes are blurred, the shape is oval or rounded. Their size is about 1-1.5 cm in diameter, the surface is smooth. Draining of roseola is not observed, nor do they rise above the skin surrounding them. There is no tendency to peripheral growth. Often, localization is concentrated in the region of the lateral surfaces of the trunk and abdomen.

This type of rash is formed in the form of nodules (papules), their shape is round and hemispherical, the consistency is densely elastic. The value can reach the size of lentils, while reaching the size of peas. The first days of appearance are characterized by the smoothness and luster of the surface of the papules, after which it begins to peel until the formation of a scaly border along the periphery, by analogy with Biett's collar. As for the localization of papules, it does not have clear areas of concentration, respectively, they can form anywhere. Meanwhile, there are also “favorite” localization environments, which include the genitals, the anus, soles and palms.

This form of formations is a frequent manifestation of papular syphilis. It is expressed in the formation of thickened nodules similar to calluses with a sharp limitation from the skin surrounding them. Their surface is smooth, the shade is erythematous-brown or lilac-red. The growth of papular elements leads to their cracking in the center, which leads to the formation of a scaly border along the circumference. Often, this form of syphilis is mistaken for ordinary calluses by patients, which does not lead to a timely visit to the doctor.

This form of rash is also quite common in the secondary stage of syphilis. Wide condylomas are papules of a vegetative type, the formation of which occurs on the basis of weeping papules with a tendency to merge and hypertrophy. Often, their accompanying feature is the formation of a deep infiltrate, covered with a white coating of the horny swollen layer in the presence of a characteristic serous discharge. Quite often, wide warts are the only manifestation characteristic of the secondary period. Most often, rashes are localized in the anus, so it is often necessary to distinguish them from condylomas of genital warts (anal warts) and from hemorrhoids.

Today it is extremely rare, but it is also impossible to exclude the possibility of this type of rash. Not so long ago, syphilitic leucoderma was such a specific manifestation of syphilis that it was given the no less striking name - “Venus's necklace”. Its manifestation is characterized in the formation of oval light rounded lesions against the background of a brownish-yellowish darkening of the skin. The most common sites of localization of syphilitic leukoderma are the lateral surfaces of the neck, in some cases in the region of the anterior chest surface, as well as in the region of the upper limbs and armpits.

This rash occurs in the form of roseolous spots that form along the mucous membrane of the mouth and throat, as well as in the region of the upper palate. The affected area is characterized by the acquisition of a stagnant red color of the surface, in some cases it may give off a copper tint. The surface is generally smooth, the outlines of the formations are clear. They are also characterized by the absence of subjective sensations, but some cases are marked by difficulties in swallowing. In the process of secondary syphilis, especially at the time of relapse of the disease, syphilides formed in the mucous membranes can act as almost the only clinical manifestation of the disease. In addition, their presence is extremely important from an epidemiological point of view, because they contain a huge number of pathogens of this infection.

Syphilitic alopecia. The main manifestation is baldness, which provokes the formation of a large number of foci of a characteristic rash. At the same time, the hair falls out so that in appearance they can be compared with fur eaten by moths.

In general, considering the rash, it can be noted that with syphilis it can be of a completely different type. The severe course of syphilis provokes the occurrence of pustular (or pustular) syphilis, which can manifest itself as a rash, and a rash characteristic of.

Secondary recurrent syphilis is characterized by fewer and fewer rashes, observed with each new form of relapse. The rashes themselves in this case become larger and larger, characterized by a tendency to their own grouping into rings, ovals and arcs.

Secondary untreated syphilis is converted to tertiary.

Symptoms of the tertiary stage

This stage of the disease is characterized by a small amount of pale treponema in the body, but it is sensitized to their effects (that is, it is allergic). This circumstance leads to the fact that even with a small amount of treponema exposure, the body responds with a peculiar form of an anaphylactic reaction, which consists in the formation of tertiary syphilides (gums and tubercles). Their subsequent disintegration occurs in such a way that characteristic scars remain on the skin. The duration of this stage can be decades, which ends with a deep lesion received by the nervous system.

Stopping on the rash of this stage, we note that the tubercles are smaller when compared with the gums, moreover, both in their size and in the depth at which they occur. Tubercular syphilis is determined by probing the thickness of the skin with the identification of 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. Tubercles appear at different times, grouping into rings.

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

Syphilide gummy is a painless dense knot, which is located in the middle of the deep skin layers. The diameter of such a node is up to 1.5 cm, while the skin above it acquires a dark red hue. Over time, the gum softens, after which it opens, releasing a sticky mass. The ulcer, which was formed at the same time, can exist for a very long time without the necessary treatment, but at the same time it will increase in size. Most often, such a rash has a solitary character.

Treatment of syphilitic rash

The rash is treated in conjunction with the treatment of the underlying disease, that is, syphilis itself. The most effective method of treatment is the use of water-soluble penicillins in it, which makes it possible to maintain a constant required concentration of the necessary antibiotic in the blood. Meanwhile, treatment is possible only in a hospital, where the drug is administered to patients for 24 days every three hours. Intolerance to penicillin provides an alternative in the form of a backup type of medication.

An additional important point is also the exclusion of diseases that have arisen against the background of syphilis. For example, syphilis often contributes to an increase in risk, because in general it provokes a sharp decrease in the immune defense that the body has. Accordingly, the appropriate solution is to conduct a full course of treatment that helps to eliminate any type of infectious agents present.

If you suspect a syphilitic rash, you should immediately contact a dermatovenerologist or venereologist.

Secondary syphilis begins with the spread of pale treponema with blood throughout the body, which usually occurs 6 to 8 weeks after the onset of a hard chancre or 9 to 10 weeks after the primary infection. In some patients, syphilitic polyadenitis persists in the initial period. In 60% of cases, patients have signs of primary syphiloma (hard chancre).

The massive release of bacteria into the bloodstream (syphilitic septicemia) is characterized by symptoms of intoxication - fever, severe headaches and muscle and joint pain, weakness, and general malaise. A rash appears on the skin and mucous membranes (secondary syphilides, secondary syphilomas), internal organs, osteoarticular and nervous systems are involved in the pathological process. Periods of a pronounced clinical picture are replaced by a hidden, latent course. Each new relapse is characterized by a decreasing number of rashes. At the same time, the rash is getting larger and less intensely colored. At the end of the second stage of syphilis, monorelapses occur, when the clinical picture is limited to a single element. At the same time, the well-being of patients suffers little. The duration of secondary syphilis is 2-5 years.

The rash with secondary syphilis is mostly resolved without a trace. The lesions of the internal organs, the musculoskeletal system and the nervous system are mainly functional in nature. In most patients, classical serological reactions are positive.

The secondary period of syphilis is the most contagious. Secondary syphilides contain a huge amount of pale treponema.

Rice. 1. Symptoms of secondary syphilis - rash (papular syphilis).

Rash with secondary syphilis

Secondary syphilis is characterized by the appearance of a rash on the skin and mucous membranes - secondary syphilides. The rash in secondary fresh syphilis is abundant and varied (polymorphic): spotted, papular, vesicular and pustular. A rash can appear on any part of the skin and mucous membranes.

The most abundant rash at the first rash, often symmetrical, the elements of the rash are small in size, always bright in color. Often, against its background, residual (hard chancre), regional lymphadenitis and polyadenitis can be detected.
Secondary recurrent syphilis is characterized by less abundant rashes. They are often grouped together to form intricate patterns in the form of garlands, rings and arcs.
The number of rashes in each subsequent relapse becomes less and less. At the end of the second stage of syphilis, monorelapses occur, when the clinical picture is limited to a single element.

The elements of the rash in secondary syphilis have some features: high prevalence at the beginning of the secondary period, sudden appearance, polymorphism, clear boundaries, peculiar coloration, lack of reaction of surrounding tissues, peripheral growth and subjective sensations, benign course (often the rash disappears spontaneously without scarring and atrophy), high infectiousness of the elements of the rash.

Rice. 2. Manifestations of secondary syphilis - syphilitic seizure.

Syphilitic roseola

Syphilitic roseola of the skin

Syphilitic roseola (spotted syphilis) is the most common form of damage to the mucous membranes and skin in early secondary syphilis. It accounts for up to 80% of all rashes. Syphilitic roseola is spots from 3 to 12 mm in diameter, from pink to dark red in color, oval or round in shape, do not rise above the surrounding tissues, there is no perifocal growth and peeling, the spots disappear with pressure, there is no pain and itching.

Roseola is caused by vascular disorders. In dilated vessels, erythrocytes decay over time, followed by the formation of hemosiderin, which causes the yellowish-brown color of old spots. Roseolas that rise above the level of the skin are often flaky.

The main localization sites of roseola are the trunk, chest, limbs, abdomen (often the palms and soles) and sometimes the forehead. Often, roseolas are located on the mucous membrane of the oral cavity, rarely - on the genitals, where they are hardly noticeable.

Elevated, papular, exudative, follicular, confluent - the main forms of spotted syphilis. With relapses of the disease, the rash is more scanty, less colored, prone to grouping with the formation of arcs and rings.

Spotted syphilis should be distinguished from bites of pubic lice, pink and, infectious roseola, measles, rubella and marbled skin.

Rice. 2. Rash with syphilis of the secondary period - syphilitic roseola.

Rice. 3. Signs of secondary syphilis - syphilitic roseola on the skin of the body.

Syphilitic roseola of mucous membranes

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

When localized on the mucous membrane of the nasal passages, dryness is noted, crusts sometimes appear on the surface. On the genitals, syphilitic roseola is rare, always hardly noticeable.

Rice. 4. Syphilitic roseola in the oral cavity - erythematous tonsillitis.

Syphilitic roseola is a typical manifestation of early secondary syphilis.

Papular syphilis

Papular syphilis is a dermal papule that forms as a result of an accumulation of cells (cellular infiltrate) located under the epidermis in the upper dermis. The elements of the rash have a rounded shape, are always clearly delimited from the surrounding tissues, and have a dense consistency. Their main locations are the trunk, limbs, face, scalp, palms and soles, oral mucosa and genitalia.

The surface of the papules is even, shiny, smooth.
The color is pale pink, copper or bluish red.
The shape of the papules is hemispherical, sometimes pointed.
They are located in isolation. Papules located in skin folds tend to grow peripherally and often coalesce. Vegetation and hypertrophy of papules leads to the formation of wide condylomas.
With peripheral growth, the resorption of papules begins from the center, resulting in the formation of various figures.
Papules located in the folds of the skin are sometimes eroded and expressed.
Depending on the size, miliary, lenticular and coin-like papules are distinguished.

Papular syphilides are extremely contagious, as they contain a huge number of pathogens. Particularly contagious are patients whose papules are located in the mouth, perineum and genitals. Shaking hands, kissing and close contact can all cause transmission.

Papular syphilides resolve in 1-3 months. With resorption of papules, peeling is noted. At first, it appears in the center, then, like a “Biette collar”, on the periphery. In place of the papules, a pigmented brown spot remains.

Papular syphilis is more characteristic of recurrent secondary syphilis.

Rice. 5. Rash with syphilis of the secondary period - papular syphilis.

Miliary papular syphilis

Miliary papular syphilis is characterized by the appearance of small dermal papules - 1 - 2 mm in diameter. Such papules are located at the mouths of the follicles, they are round or cone-shaped, dense, covered with scales, sometimes with horny spines. The trunk and limbs are their main localization sites. The resolution of papules is slow. A scar remains in their place.

Miliary papular syphilis should be distinguished from lichen scrofula and trichophytosis.

Miliary syphilis is a rare manifestation of secondary syphilis.

Lenticular papular syphilis

Lenticular papules are formed on the 2nd - 3rd year of the disease. This is the most common type of papular syphilis, occurring in both early and late secondary syphilis.

The size of the papules is 0.3-0.5 cm in diameter, they are smooth and shiny, rounded with a truncated top, have clear contours, pink-red color, when pressed with a bellied probe, pain is noted. As the papules develop, they become yellowish-brown in color, flatten, covered with transparent scales. The marginal type of peeling is characteristic ("Biett's collar").

During the period of early syphilis, lenticular papules can appear on different parts of the body, but most often they appear on the face, palms and soles. During the period of recurrent syphilis, the number of papules is less, they are prone to grouping, and bizarre patterns are formed - garlands, rings and arcs.

Lenticular papular syphilis should be distinguished from guttate parapsoriasis, lichen planus, psoriasis vulgaris, papulonecrotic.

On the palms and soles of the papules are reddish in color with a pronounced cyanotic tinge, without clear boundaries. Over time, the papules become yellowish in color and begin to peel off. The marginal type of peeling is characteristic ("Biett's collar").

Sometimes the papules take on the appearance of calluses (horny papules).

Palmar and plantar syphilides should be distinguished from eczema, athlete's foot and psoriasis.

Lenticular papular syphilis occurs in both early and late secondary syphilis.

Rice. 6. Lenticular papules in secondary syphilis.

Rice. 7. Palmar syphilis in secondary syphilis.

Rice. 8. Plantar syphilis with secondary syphilis

Rice. 9. Secondary syphilis. Papules on the scalp.

Coin papular syphilis

Coin-like papules appear in patients during the period of recurrent syphilis, in a small amount, bluish-red in color, have a hemispherical shape, 2–2.5 cm in diameter, but may be larger. With resorption, pigmentation or an atrophic scar remains in place of the papules. Sometimes around the coin-shaped papule there are many small ones (brisant syphilis). Sometimes the papule is located inside the annular infiltrate, between it and the infiltrate there is a strip of normal skin (a kind of cockade). When the coin-shaped papules merge, plaque syphilis is formed.

Rice. 10. A sign of syphilis of the secondary period is psoriasiform syphilis (photo on the left) and nummular (coin-shaped) syphilis (photo on the right).

Wide type of papular syphilis

A wide type of papular syphilis is characterized by the appearance of large papules. Their size sometimes reaches 6 cm. They are sharply demarcated from healthy areas of the skin, covered with a thick stratum corneum, and dotted with cracks. They are a sign of recurrent syphilis.

seborrheic papular syphilis

Seborrheic papular syphilis often appears in places with increased sebum secretion - on the forehead ("crown of Venus"). Oily scales are located on the surface of the papules.

Rice. 11. Seborrheic papules on the forehead.

Weeping papular syphilis

Weeping syphilide appears on areas of the skin where there is increased humidity and sweating - the anus, interdigital spaces, genitals, large skin folds. Papules in these places undergo maceration, weeping, acquire a whitish color. They are the most contagious form among all secondary syphilides.

Weeping syphilide must be distinguished from folliculitis, infectious mollusk, hemorrhoids, chancre, pemphigus and epidermophytosis.

Rice. 12. Secondary syphilis. Moist and erosive papules, wide warts.

Erosive and ulcerative papules

Erosive papules develop in case of prolonged irritation of their localization sites. When a secondary infection is attached, ulcerative papules are formed. The perineum and anus are common sites of their localization.

Wide warts

Papules that are subject to constant friction and wetting (the anus, perineum, genitals, inguinal, less often axillary folds) sometimes hypertrophy (increase in size), vegetate (grow) and turn into wide condylomas. Contribute to the appearance of genital warts vaginal discharge.

Rice. 13. With the growth of papules, wide warts are formed.

Vesicular syphilis

Vesicular syphilis occurs in severe syphilis. The main places of localization of syphilides are the skin of the extremities and the trunk. On the surface of the formed plaque, which has a red color, there are many grouped small vesicles (vesicles) with transparent contents. The vesicles burst rapidly. In their place, small erosions appear, when they dry, crusts form on the surface of the rash. When cured, a pigment spot with many small scars remains at the site of the lesion.

Rashes show resistance to ongoing therapy. With subsequent relapses, they reappear. Vesicular syphilide should be distinguished from toxidermia, simple and acute herpes.

Pustular syphilis

Pustular syphilis, like vesicular, are rare, usually in debilitated patients with low immunity and have a malignant course. With the disease, the general condition of the patient suffers. Symptoms such as fever, headache, severe weakness, joint and muscle pain appear. Quite often classical give negative results.

Acne, pox, impetiginous, syphilitic ecthyma and rupee are the main types of pustular syphilis. Rashes of this type are similar to dermatoses. Their distinguishing feature is an infiltrate in the form of a roller located along the periphery of a copper-red color. The occurrence of pustular syphilis is facilitated by diseases such as alcoholism, toxic and drug addiction, tuberculosis, malaria, hypovitaminosis, and trauma.

Acne (acneform) syphilis

Rashes are small pustules of a rounded conical shape with a dense base, located at the mouths of the follicles. After drying, a crust forms on the surface of the pustules, which disappears after a few days. In its place remains a depressed scar. The scalp, neck, forehead, upper half of the body are the main locations of acne syphilis. In a large number of elements of the rash appear during the period of early secondary syphilis, meager rashes - during the period of recurrent syphilis. The general condition of the patient suffers little.

Acne syphilis should be distinguished from acne and papulonecrotic tuberculosis.

Rice. 14. Rash with syphilis - acne syphilis.

Smallpox syphilis

Smallpox syphilis usually occurs in debilitated patients. Pustules the size of a pea are located on a dense base, surrounded by a roller of copper-red color. When dried, the pustule becomes similar to smallpox. In place of the fallen crust, brown pigmentation or an atrophic scar remains. Eruptions are not profuse. Their number does not exceed 20.

Rice. 15. In the photo, the manifestations of secondary syphilis are pox-like syphilis.

Impetiginous syphilis

With impetiginous syphilis, a dark red papule the size of a pea or more first appears. A few days later, the papule suppurates and shrinks into a crust. However, the discharge of the pustules continues to stand out on the surface and shrinks again, forming a new crust. Layering can become large. The formed elements rise above the level of the skin. When syphilides merge, large plaques are formed. After rejection of the crusts, a juicy red bottom is exposed. Vegetative growths resemble raspberries.

Impetiginous syphilide, located on the scalp, nasolabial fold, beard and pubis, is similar to a fungal infection - deep trichophytosis. In some cases, the ulcers merge, forming extensive lesions (corrosive syphilides).

The healing of syphilis is long. Pigmentation remains at the site of the lesion, which disappears over time.

Impetiginous syphilide should be distinguished from impetiginous pyoderma.

Rice. 16. In the photo, a variety of pustular syphilis is impetiginous syphilis.

Syphilitic ecthyma

Syphilitic ecthyma is a severe form of pustular syphilis. Appears 5 months after infection, earlier - in debilitated patients. Deep pustules are covered with powerful crusts up to 3 or more centimeters in diameter, they are thick, dense, layered. The elements of the rash rise above the surface of the skin. They have a rounded shape, sometimes irregular oval. After rejection of the crusts, ulcers with dense edges and a cyanotic rim are exposed. The number of ektims is small (no more than five). The main places of localization are the limbs (often the lower leg). Healing occurs slowly, over 2 or more weeks. Ecthymas are superficial and deep. Serological tests sometimes give a negative result. Syphilitic ecthyma must be distinguished from ecthyma vulgaris.

Rice. 17. Secondary syphilis. A variety of pustular syphilis is syphilitic ecthyma.

Syphilitic rupee

A variety of ecthyma is the syphilitic rupee. The lesions are 3 to 5 centimeters in diameter. They are deep ulcers with steep infiltrated edges, covered with a dirty bloody discharge, which, when dried, form a cone-shaped crust. The scar heals slowly. It is often located on the legs. It spreads both along the periphery and in depth. It is combined with other syphilides. It should be distinguished from rupioid pyoderma.

Rice. 19. In the photo, the symptoms of malignant syphilis of the secondary period are deep skin lesions: multiple papules, syphilitic ecthymas and rupees.

Herpetiform syphilis

Herpetiform or vesicular syphilis is extremely rare and is a manifestation of severe secondary syphilis in patients with a sharp decrease in immunity and severe concomitant diseases. The patient's condition is deteriorating significantly.

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