What does a syphilitic rash look like at different stages of syphilis? What does a rash look like at different periods of syphilis: description and photo Cutaneous manifestations of syphilis.

Cutaneous manifestations of syphilis vary significantly depending on the stage of the course of venereal pathology. Often, changes in the skin are similar to signs of autoimmune, allergic, or infectious lesions. In this case, laboratory diagnostics are carried out to differentiate from atopic dermatitis, shingles, rubella or measles.

In this article, we will analyze what skin changes are characteristic of syphilis at each stage of the infectious process.

No skin lesions during the incubation period

The emergence of syphilis of the skin and other organs and systems is associated with the penetration of pale treponema into the human body through the skin and mucous membranes, the integrity of which was violated for various reasons. From this moment, the incubation period begins, during which pale treponemes begin to actively grow and multiply. If at this stage laboratory studies of biological samples are carried out, then their results will not show the presence of these microorganisms.

Depending on the state of health of the person and the chronic diseases he has, the duration of the incubation period varies from a week to a month. In some cases, the first pronounced symptoms develop only six months later.

If during the incubation period an infected person 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 a part of pale treponemas. The carrier time 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 the appearance of a hard 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. In addition to skin manifestations, the following symptoms appear in an infected person by the end of the initial stage of a venereal disease:

• hyperthermia;
• headaches and musculoskeletal pains;
• weakness, fatigue.

Skin lesion at the first stage

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 circulation.

“Warning: Timely diagnosis of venereal pathology is hampered by the lack of basic knowledge in a person about the symptoms of syphilis. Infected people mistake it for microtrauma and begin to treat it with local antiseptics, while gram-negative spirochetes are actively multiplying in the body. "

At the base of the hard chancre, an accumulation of cellular elements with an admixture of blood and lymph is observed. Sometimes, in the absence of qualified medical care, the chancre spreads into the deeper layers of the epidermis and acquires the structure of cartilage 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. The infected take the healing of syphiloma for complete recovery and do not go to a hospital.

Where syphiloma is most often formed:

• the ulcer affects the genitals, scrotum, pubic region in men;

• in women, the chancre can be localized on the large and small labia, clitoris, cervix.
• this primary symptom of syphilis is found near the 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 dm 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 mainly red and blue shades prevail in the color of the ulcer. When pressing on syphilitic lesions, painful sensations are absent or slightly expressed.

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

• Inductive ulcer. This type of chancre is characterized by the formation of pronounced swelling, extending beyond the skin damage. The color of the seal varies considerably. Formed syphilomas can be bluish-red or pink in color. Puffiness most often affects the labia in women and the foreskin in men. Inductive ulcers do not disappear within 2-3 months, and if untreated, they provoke numerous complications.
• Chancre-panaritium. Syphilitic clinical manifestation occurs on the nail bed and refers to bone pathologies. At the site of the lesion, a strong inflammatory process develops, the result of which is the formation of an open wound, often with purulent contents. The finger swells up and turns bluish-red. The pain is so severe that it is only temporarily stopped by non-steroidal anti-inflammatory drugs. With extensive suppuration, the nail is rejected. Treatment often involves a series of surgical procedures.
• Amygdalid. This type of hard chancre affects the tonsils located in the upper respiratory tract. This symptom of syphilis is very similar to the main clinical manifestation of follicular or lacunar sore throat. The tonsil becomes dark blue, swells, provokes severe pain when swallowing. This is all accompanied by symptoms of general intoxication, therefore, to differentiate it from respiratory infections, a number of laboratory serological studies are carried out.

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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. Infectious pathogens are carried by the bloodstream to the internal organs, provoking a decrease in their functional activity. The infected person's body temperature rises, joint and muscle pain occurs, and psychoemotional disorders develop. But the most pronounced symptom in the clinical picture is skin rashes of various localization, shape and color of spots.

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

• characteristic coloration;
• 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 (the outdated name - lues) flows into its severe chronic form, which is characterized by frequent changes in remissions with painful relapses. At the end of this stage of syphilis, gummas of the Tertiary period are often formed on the skin.

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

Syphilitic roseola

At an early stage of secondary syphilis, in the vast majority of cases, patients are diagnosed with syphilitic roseola on the skin and mucous membranes. Outwardly, the formation looks like a spot, the sizes of which vary from 2.5 mm to 1 cm in diameter. The coloration is also quite different. Roseola are pale pink or crimson red. When pressed, the round or elongated spots disappear, while the pain syndrome is completely absent.

Syphilitic roseola occurs as a result of a deterioration in the condition of blood vessels and a deficiency of red blood cells. The lack of red blood cells provokes the impossibility of optimal provision of tissues with molecular oxygen. Stagnation occurs in the subcutaneous tissue, causing a grayish-yellow color of old spots. For syphilis on the skin and mucous membranes, various shapes and sizes of roseola are characteristic. What are the main differences:

• Rashes on the skin may rise slightly above their surface. Often flaky roseola are localized on the trunk, chest, abdomen, palms, soles, and sometimes affect the face, especially the forehead. Rashes during relapses often merge with each other, forming one large spot. In this case, 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 borders. Syphilitic roseola does not itch; when pressed, a person does not experience any painful sensations. When a rash forms on the mucous membranes of the nasal passages, dry crusts are often formed as a result of swelling and microcirculation disorders. This can lead to nasal congestion and breathing difficulties.

Before the initial diagnosis is made, patients are examined and laboratory tests are prescribed. According to their results, venereologists differentiate syphiloma from pubic lice, pityriasis versicolor, as well as other infectious and autoimmune skin lesions.

Papular syphilis

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 a liquid content and are located directly in the upper layer of the epidermis. Usually, venereologists diagnose such rashes on the abdomen, 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.

An infectious disease, in 99% of cases transmitted through sexual contact and affects the entire body. The causative agent of the pathology is considered to be pale treponema - a bacterial pathogen, one of the signs of the presence of which are characteristic spots. What are the spots on the body with syphilis? And what are the ulcers for syphilis?

The period of syphilis is considered primary from the moment of infection to 2-3 months, when a hard chancre forms in the area of ​​infection:

1. First, there is a slight redness, in the place of which a bulge forms after a few days.
2. In the middle of the formation, cell death occurs, so soon the chancre turns into an insensitive ulcer, framed by a solid ring.

The first stage of syphilis ends with characteristic rashes on the body - the result of the vital activity of pale treponema. Skin problems are accompanied by intoxication phenomena:

• general weakness and joint pain;

• an increase in body temperature;

• decreased vitality.

The totality of all signs indicates the beginning of the next stage in the development of syphilis.

Spots with secondary syphilis

The second stage is longer. It lasts up to 4 years and manifests itself on the skin in a variety of ways. Surface elements of this period are classified into:

• Roseolous syphilides, the appearance of which indicates that the body contains a huge amount of bacteria-pathogen. The color of the spots is weak, the outlines are slightly blurred, the shape resembles an oval or circle with a diameter of up to one and a half centimeters. Roseols do not unite and are flush with the skin surface. The area of ​​their localization is the sides and abdomen.
• Papular syphilis resembling nodules (papules). They have the appearance of a circle or hemisphere the size of a lentil grain, dense to the touch. Initially, the papules are smooth and shiny, but soon signs of peeling become visible on the surface, and a border forms around the perimeter. The area of ​​localization of papular syphilides is the whole body, including the groin, palms and feet.

Papular syphilis

• Palmar-plantar syphilis- one of the forms of elements mentioned above. Outwardly, they resemble dark red corn spots. An increase in the volume of formations causes them to crack in the center, which entails the formation of a flaky halo around the perimeter of the circle. Often, patients confuse palmar-plantar papules with ordinary rubbing from shoes, so they do not rush to see a doctor and start treatment late.
• Wide warts... In fact, these are vegetative papules. They can combine to form hypertrophied areas. They are covered with a white layer of swollen stratum corneum, under which there is a serous infiltrate. Wide warts in some cases may be the only cutaneous symptom of secondary syphilis. A favorite place of localization is the perianal region, therefore, when examining a neoplasm, it must be differentiated from anal warts and manifestations of hemorrhoids.
• Syphilitic leucoderma... They are observed infrequently and are considered a specific manifestation of syphilis. Accumulations of elements of a rash on the chest and neck are romantically referred to by doctors as the "Necklace of Venus". Separately taken leucoderma looks like a light oval on a dark brown spot. In addition to the front of the upper body, the rash can cover the arms and armpits.

Syphilitic leucoderma

Skin formations characteristic of tertiary syphilis lead to the development of conditions such as:

1. Erythematous sore throat... Its characteristic feature is considered to be spots on the body of roseola, covering the mucous membrane of the organs of the oral cavity. They are distinguished by a dark red hue, a smooth surface and clear boundaries. Roseola on the mucous membrane does not hurt, but can make it difficult to swallow saliva and food. Syphilis in the mouth with relapses in the third stage of syphilis may be the only external manifestation of the disease;
2. Syphilitic alopecia. This is baldness caused by a large number of specific elements on the scalp. Hair breaks down and falls out unevenly, like particles of fur, "beaten" by moths.

It is important to understand that a person on whose body there are syphilis is dangerous due to the ability to "share" the infection upon contact, since the elements of the rash contain a large amount of the pathogenic bacteria.

Syphilitic alopecia

So, a syphilitic rash can be represented by spots and other elements of various types. In this case, the severe course of the pathology is accompanied by pustular (pustular) syphilides, reminiscent of smallpox, acne or impetigo. A characteristic feature of the secondary period is also the fact that with each new relapse the number of spots on the body decreases, but the elements themselves become larger, form clusters resembling circles and arcs.

Against the background of the lack of treatment or improper therapy, secondary syphilis enters the next stage.

Spots and ulcers in tertiary syphilis

This degree of pathology is ascertained 7-10 years later after pale treponema enters the body. Currently, tertiary syphilis occurs in patients who neglect the doctor's prescriptions, partially or completely violating them.

What do you think, is there a chance to be cured in the third stage of syphilis?

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The cutaneous manifestations of this period - tertiary syphilides - develop over months and years without giving symptoms of inflammation and without causing discomfort. Unlike the formations of secondary syphilis, these are located compactly, occupying a limited area of ​​the body and gradually regressing, transforming into skin scars.

External manifestations of tertiary syphilis include:

1. Tuberous syphilides... These are dense syphilis spots-bulges of a brownish tint, containing infiltration. They are up to 7 mm in diameter. In the accumulation of syphilis, elements of varying degrees of development can be distinguished. After a while, the tubercle necrotizes, forming ulcers in syphilis, containing infiltration. It takes weeks and months to heal, after which a small area of ​​atrophy or a scar remains on the body.
2. Gummy syphilides, which are represented by one or more single elements on the body. Gumma, in fact, is a painless lump under the skin, the site of which can be localized in the forehead, lower legs and forearms, elbows and knees. At the initial stage of formation, the node is mobile. Over time, it grows and fuses with the surrounding tissues, turning into a static subcutaneous formation. A hole looms in the center through which gelatinous discharge flows out. Soon, the depression takes the form of a crater, at the bottom of which is a necrotic rod. After its release, the ulcer quickly heals, forming a concave star-shaped scar. There are cases when gummas are resolved, bypassing the stage of an ulcer: the node simply becomes smaller, and over time it is replaced by connective tissue.

Tuberous syphilides

In addition to the thickness of the skin, gummy syphilides affect:

• cartilage and bones;

• muscles and blood vessels.

In the long term, this leads to the inevitable destruction of the body.

Treatment and prevention

A dermatovenerologist deals with the treatment of syphilis and other sexually transmitted diseases. The therapy takes a long time. When referring in the early stages, its duration reaches 3 months, and at later stages it stretches for years. The fact of the cure is confirmed solely by the results of laboratory tests, and not by the patient's statements about the improvement in well-being.

It is important to understand that it is easier to avoid syphilis than to cure it. In this article, you can find out

To combat syphilis, water-soluble antibiotics of the penicillin series are used, which are administered intramuscularly at regular intervals in a course of several weeks. In case of intolerance, they can be replaced with tetracyclines, fluoroquinols, macrolides. In addition to antibacterial injections, syphilis sufferers are prescribed immunostimulants and vitamin preparations.

To avoid contracting syphilis, simple but important prevention rules should be followed:

• use of personal hygiene products;
• avoiding kissing and sexual intercourse with unfamiliar partners;
• the use of barrier contraception (condoms);
• a visit to a dermatovenerologist after unprotected sex with a person whose health condition is unknown;
• refusal of self-medication when signs of a sexually transmitted disease are detected, as this is fraught with serious complications in the future.

If it so happens that the infection has occurred, it is worth remembering that modern medicine has a sufficient arsenal of tools and capabilities to successfully fight syphilis. The sooner you seek medical help, the greater the chances of early healing.

Video

You can also watch a video where a venereologist will tell you about the symptoms of syphilis in men and women.

When spots from syphilis appear on the skin, it is unpleasant and frightening, like any sign of a serious illness. But this is not a reason for fear and despair, but only a reason to consult a doctor for diagnosis and treatment.

Among the many sexually transmitted diseases, syphilis occupies a special place. The causative agent of the disease is a pale spirochete (treponema). The characteristic rash with syphilis is the first manifestation of the disease. Below is detailed information on syphilis rash, early signs of illness, treatment, and how to prevent illness.

Syphilis is a dangerous venereal disease characterized by treponema affecting all organ tissues. Transmission of infection can occur through sexual, contact-household way (in contact with an open wound or mucous membranes of the sick person), while carrying out a blood transfusion in a hospital. There is a possibility of transmission of the disease to the fetus through the placenta. The symptoms of the disease are different, depending on the stage of the disease. There are 4 main periods of the disease:

When examining a patient, a venereologist determines the disease by how the rash looks. Usually, skin lesions appear on the abdomen, the skin of the genitals. The rash spreads to the scalp covered with hair, to the skin under the mammary glands in women. The skin of the genitals lends itself to ulcers (if infected after sexual contact): the penis of a man, in a woman - the cervix, vagina, labia.

Since the disease has vivid characteristic manifestations, a specialist can easily determine the diagnosis. Timely access to a doctor and surgical treatment of the disease in the early stages lead to a quick cure for the disease.

Characteristic signs of a syphilitic rash

Sometimes, when infected with syphilis, a rash on the skin is accompanied by symptoms of a cold, rarely flu. Syphilitic rashes on the skin have certain characteristic features:

• there is no specific localization of rashes, their concentration;
• lesions on the skin do not hurt, do not itch, do not peel off;
• lesions have a dense surface, rounded;
• the rash does not always stick together;
• rashes can be pinkish, red, bluish;
• the rashes themselves disappear without a trace.

The timely start of treatment with mandatory follow-up treatment until the disease is completely eliminated is of great importance. The advanced stages of the disease are terrible in their complications, difficult to cure. You can completely cure the disease if you start treatment at the first or second stages of the development of the disease.

Manifestations of syphilitic eruptions

A rash on the body with syphilis, which has arisen at the primary stage, is manifested by medium-sized reddish spots, which after a short period of time transform into small bumps. In their place, wounds with dense edges are formed. The lymph nodes of a sick person become enlarged. The duration of the period reaches seven weeks. The primary stage ends with sepsis (blood infection), joint pain, fever, and general weakness.

Secondary stage of the disease

The disease in the secondary stage can manifest itself in different ways. Therefore, the doctor can not always accurately diagnose. Syphilitic eruptions are easily confused with other skin diseases. There are distinctive features of the manifestation of a rash caused by syphilis, which are characteristic of the disease precisely in the secondary stage:

• the rash does not hurt or itch;
• neoplasms have fairly dense clear edges;
• the bumps have a rich red tint;
• rashes suddenly appear, passing without a trace.

A rash with spots turns into the formation of abscesses, which entail a general infection of the body. Pus from the wounds is saturated with the causative agent of the disease, it can be contagious to the people around.

The manifestations of a rash that appeared in the secondary stage of the disease have the following features:

Tertiary stage of syphilis

At the tertiary stage of the course of the disease, the papules are of a medium size, their structure is determined by the doctor during palpation by the color of the skin over the papule (the color is reddish-cyanotic). The tubercles are grouped on the skin. Papules turn into small wounds, after which scars and scars remain.

Tertiary syphilis is difficult to treat and usually cannot be completely cured. There are complications of the disease, disability, transmission of infection from mother to child. With serious complications, the death of the sick person can occur.

All stages of the disease can provoke the development of other serious diseases. Complications of the tertiary stage can be:

• meningitis (inflammation of the meninges);
• neuritis (inflammation of the peripheral nerves);
• osteoarthritis (degenerative-dystrophic joint disease);
• osteoperiostitis (inflammation of the bone walls of the orbit);
• aortitis (inflammation of the aortic wall);
• myocarditis (inflammation of the heart muscle);
• gastritis (inflammation of the stomach lining);
• hepatitis (inflammatory liver disease);
• necrosis (tissue necrosis);
• blindness.

Diagnostics of the syphilitic infection

After examining the external manifestations of the disease, the attending physician must prescribe a blood test for syphilis. One analysis (Wasserman reaction) will not fully reveal the picture of the disease. The task of the study of a blood sample is to detect special antibodies that the body of an infected person produces in the presence of syphilis in the blood. For the study, blood is taken from a vein on an empty stomach - so the analysis will be the most objective. If the test is positive, the diagnosis is confirmed. If negative, there is no syphilis, the cause of the skin rash is being investigated.

A blood test for syphilis can give a false result. This may be due to:

• early illness (several days have passed after infection);
• the disease is in the secondary or tertiary stage (the amount of contained protective antibodies is significantly reduced).

With a positive result, blood tests for syphilis are repeated. False test results are common.

Syphilitic therapy

Syphilitic rashes occur with repeated relapse (in the primary and secondary stages of syphilis). At the initial stage, a hard chancre appears - a red wound with smooth rounded edges. The resulting erosion is not subject to local treatment, its size does not increase.

Infection with the disease often occurs through sexual contact, but contact and household are possible. The mode of infection often determines what kind of rash with syphilis manifests itself in an infected person. On the areas of the skin where contact with the sick person has occurred, the first manifestations of the infection will appear there.

Erosion in the primary stage of the disease affects the mucous membranes of the oral cavity, tonsils, anus, the skin of the hands, in the lower abdomen, under the mammary glands in women.

In males, the foreskin of the penis, its entire skin, and the urethra are affected by infection. For female representatives - the surface of the labia, the perineum, the area of ​​the anus. The vagina and cervix are affected by ulcers. The neoplasms pass on their own after two months without complications.

Seven days after the appearance of the first chancre, an increase in the size of the lymph nodes (often in the groin) occurs, accompanied by a general weakening of the body, muscle and joint pain. These phenomena indicate the spread of syphilis throughout the patient's body.

In the secondary stage of the disease, rashes occur 2-4 months after infection. The ulcers are localized in the mucous membranes and on the skin, after 1.5-2 months they are eliminated, reappearing. The secondary stage of the disease lasts a long time - from 2 to 7 years. Syphilis affects all organs, tissues, fluids in the human body, causing irreparable harm. It is quite difficult to treat advanced forms of the disease. Launching the development of a disease means risking your life. If irreversible processes occur, syphilis cannot be cured.

The first time the rash occurs profusely, has an expressive red tint. All subsequent appearances of the rash each time have a paler color, fewer ulcers.

Treatment of the disease should be carried out in a timely manner with the manifestation of the general picture of the disease, preventing the development of complications of the disease. A specialist, based on the examination of the patient, the results of blood tests, will determine an accurate diagnosis. The method of treatment will depend on the individual characteristics of the patient's body, the intensity of the course of the disease.

Treatment of syphilis is carried out in a comprehensive manner, including elimination of infection from the body, therapy of the main external problem - a rash. Treatment is carried out with the introduction of antibiotics to prevent reproduction, the spread of infection, and the destruction of the causative agent of the disease. Water-soluble penicillin is often used, but in case of individual intolerance (allergy), another effective antibiotic is prescribed. Depending on the stage of the disease, its intensity, immunostimulating therapy is carried out.

Preventive measures

Immediately after infection, syphilis does not appear in any way. After sexual contact without protection, it is recommended to treat the external genital organs, skin in places of contact with soap and an antiseptic. You can use antiseptic solutions: Chlorhexidine, Miramistin. Women douche the vagina, males inject an antiseptic into the urethra.

The method can reduce the likelihood of penetration of pathogens by 70%. It is not always possible to carry out procedures in a timely manner, and the risk of infection is too great even after treatment with antiseptics. During sexual intercourse, even with proven partners, it is recommended to protect yourself with condoms. This will save not only women from unwanted pregnancy, but also from a number of dangerous sexually transmitted infections.

After accidental unprotected sexual intercourse, it is recommended to visit a doctor no earlier than 2-3 weeks later. Before this period, the infection will not appear.

All damaged skin surfaces of an infected person are infectious. Short-term contact can be dangerous. To prevent the transmission of syphilis from a sick person to his healthy family members, you need to adhere to sanitary and hygienic rules. The sick person, if possible, should be isolated, have separate dishes, bed linen, and personal hygiene items. Contact with the patient should be limited, the infected person remains infectious until complete recovery.

Syphilis is a common sexually transmitted disease that is primarily sexually transmitted. The disease is accompanied by a characteristic rash, which is the main symptom of infection. In the treatment of an ailment, timely access to a doctor is of great importance. The disease is successfully treated in the early stages. A neglected disease is difficult to treat. With the activation of irreversible processes in the body, treatment does not help, a lethal outcome occurs.

Syphilis refers to severe systemic infections transmitted sexually, through household contact, or by blood transfusion. By and large, the causative agent of the disease, the microorganism pale treponema, is quite sensitive to quite standard antibacterial drugs from the group of penicillins, tetracyclines.

The main thing is to clearly observe the dosage and duration of admission. However, in the absence of therapy, there is a high risk of transition of pathology to a chronic, recurrent form. A rash with syphilis occurs already at the secondary stage of the process, therefore such a symptom is a serious reason for contacting a venereologist as soon as possible.

Unlike most dermatoses, rashes with treponema pallidum are characterized by a number of signs:

• there is no specific localization of lesions of the epidermal cover, the only exception is the hard chancre, specific for primary syphilis, which forms at the site of the introduction of treponemes into the skin or mucous membranes;
• there is no predisposition to the fusion of foci of rashes, as a rule, the foci have a well-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;
• there are no additional symptoms, itching, peeling are not characteristic of syphilitic rashes, the general well-being remains within the normal range, with rare exceptions after the disappearance of the rash, no traces appear on the skin;
• the shade of the lesions varies from pale-flesh at the initial stage to red-brown to black;
• the simultaneous presence of several types of rash (for example, spots and papules) is possible;
• rapid disappearance with the selection of the appropriate course of therapy.

Its useful to note

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

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

Its useful to note

Approximately from the moment of infection to the appearance of foci of lesions on the body, it takes up to 10-15 weeks. However, in some cases (for example, when treponema gets into the body during a blood transfusion from a patient), rashes appear earlier.

A person does not immediately find out about infection with syphilis, since the disease begins with the incubation period. Its duration depends on the state of the immune system, the presence of concomitant diseases, and concurrent administration of antibiotics (standard dosages for the treatment of the vast majority of bacterial infections are not fully effective in combating treponema). The primary form of syphilis is characterized by the appearance of the so-called hard chancre. Outwardly, it looks like a rounded ulcer surrounded by a raised roller.

The inner surface is flat and smooth. However, such a skin lesion is painless, when rubbing with clothes or pressing, an ichor can be released. Typically, a chancre forms on an area of ​​the body that has been in direct contact with infected secretions. Usually these are the genitals, during medical manipulations or after unprotected oral sex - the mucous membrane of the nasopharynx. Less commonly, a similar sign of syphilis is formed on the abdomen, 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 lining is single, but sometimes multiple ulcerations may appear. A rare atypical form of primary syphilis is chancre - panaritium. Its distinctive feature is localization, atypical for this disease - on the palms, fingers. In this case, in addition to the ulcer, there is swelling, local hyperthermia, redness.

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, it is this stage that is characterized by the appearance of various kinds of rashes. Previously, the pathogenesis of such a course of syphilis was associated with the activity of the treponemes themselves. But in the course of clinical studies, scientists found out that the main physiological reason for the formation of certain symptoms reflecting the stages of pathology is the response of the body.

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

Syphilitic roseola

In appearance, such a formation is a stain that does not differ in any way from the surrounding skin except for color. The hue can range from pale-flesh-colored or slightly yellowish to bright red. However, in the vast majority of cases, syphilitic roseola does not have a very contrasting color.

Its useful to note

For the same person, the shade of the spots sometimes differs.

The shape of the rash is variable: spots can be round or have indistinct borders. They are located at a distance from each other, do not merge together. The size of each individual lesion ranges from a few millimeters to one and a half centimeters. Itching, peeling, inflammation of the surrounding tissues is absent.

In the cold, roseola spots become more distinct, the same symptoms are noted at the beginning of therapy with penicillin antibiotics. When pressed, the rash disappears, but after some time it returns again. A distinctive feature of this syndrome is the acquisition of a more intense color when injected with a solution of vitamin PP.

Papular syphilis

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. By itself, the rash does not cause any discomfort, but when pressed, there is an acute painful sensation. As a rule, papules remain on the body for up to 2 months, after which peeling occurs, then the rash disappears. In their place, areas of pigmentation remain for some time.

There are such forms of papular syphilis:

• Lenticular, appears most often, an outwardly 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 appearance 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 syphilis is characterized by the fusion of rashes into groups of different outlines - a semicircle, an arc ring, etc.
• Miliart, with this form of syphilis, papules do not exceed a few millimeters, they are formed only around the hair follicles (including the cannon) or the ducts of the sebaceous glands. In terms of consistency, the formations are quite dense, sometimes covered with a horny coating. As a rule, miliary syphilis is localized on the arms and legs. Such formations can be accompanied by itching, are prone to a prolonged course, and do not respond well to standard therapy.
• Coin-shaped, differs in the large size of papules (up to 2.5 cm) of a rather characteristic color (from dark brown to violet-red). Usually there are relatively few rashes, in addition, a similar form of syphilis tends to be combined with other types of rashes. Often, the focus of the lesion resembles a fireworks - several small ones are located around a large spot (a similar phenomenon is called blasting or corymbiform syphilis). After the disappearance of the coin-like papule, areas of impaired pigmentation remain. Often, such formations are localized in the area of ​​the groin folds, between the buttocks. In this case, they are often damaged, wet, and constantly eroded.

Sometimes the so-called palmar and plantar syphilis is formed. In appearance, they may resemble corns or subcutaneous hematomas, which, as it were, "shine through" through the epidermal cover.

Pustular syphilis

This form of the disease proceeds with the formation of filled exudates of bubbles of various sizes and localization. According to experts, it is very rare, in a maximum of 10 patients out of 100, more typical for patients with a weakened immune system, against the background of alcohol and drug abuse. It is not uncommon for this rash to be accompanied by severe fever.

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

• Eel-like... It manifests as a small lump, in the middle of which an accumulation of pus quickly appears. Usually they have a bright color, as a rule, they are localized in the area of ​​the sebaceous glands (on the face, back, hair growth zone on the head).
• Smallpox... It is characterized by the rapid disintegration of the pustule into a papule surrounded by inflammatory skin. Subsequently, it becomes covered with a dense keratinized crust, soon it disappears, and a small depression remains. The rashes are not prone to fusion, outwardly resemble chickenpox, therefore, a number of studies are required for differential diagnosis.
• Impetiginous... At the initial stage, a characteristic pustule appears, which gradually collapses in the central part, forming a rather large abscess. The rash has a bright red color, after the rupture of the abscess, a yellowish or brown dense crust forms.
• Ektim... Characterized by the depth of the process, the pathology covers not only the epidermis, but also the dermis. It is large (up to 10 cm), often covered with a dense crust. It soon falls off, exposing an ulcerative surface bounded by raised skin. After healing, a scar forms at the site of the ecthyma.

Another type of pustular syphilis is the rupee. 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.

Herpetiform syphilide

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

Pigmented syphilide

This form of the disease is also called leukoderma. Usually, its manifestations occur six months after infection. Pigmented syphilis is localized in the neck area, therefore it is often called the necklace of Venus. Initially, the skin appears to have increased pigmentation with uneven outlines, then they brighten. They are not prone to change in size and fusion, they are more often formed in women, as a rule, it is difficult to respond to therapy. 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 the background of long-term inflammatory processes in the epidermis and dermis. One of the manifestations of the late period of the disease is gum - a rather dense neoplasm, its size can reach a walnut. When pressed, no painful sensations arise.

Gum is formed in the epidermis, therefore it easily moves under the skin, usually forms on the legs, can be singular or merge together. After some time, tissue fluid is released from the middle of the formation. 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 a depression in the skin may form. Lumpy syphilis is another manifestation of tertiary syphilis.

It is accompanied by the formation of formations of a specific bluish tint, collected in groups. Depending on the individual characteristics of the patient, they can dissolve or flow into ulcers with subsequent scarring.

The clinical picture of congenital syphilis

An infant infected with syphilis intrauterinely has a high probability of death, especially with an early manifestation of pathology. 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, the appearance of a bright red hue. Papular syphilis in children occurs with thickening of the skin on the soles and palms, buttocks. Then the surface of such a formation becomes shiny, and begins to peel off strongly.

With the formation of symptoms of syphilis in the mouth as a result of sucking, 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.

Its useful to note

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

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

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

In men, the initial manifestations of pathology (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 of the infectious process. With intrauterine infection of a developing fetus, there is a high risk of death of the child, a similar probability persists in the postpartum period.

Its useful to note

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

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

This is possible with the help of microscopy of the discharge and specific immunoassay methods, hemagglutination reaction, Wasserman. They can give an unreliable result at the initial stages of the disease, however, when skin manifestations occur, such techniques are very specific.

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

Red spots in syphilis are a rather unpleasant phenomenon, and sooner or later they appear in an infected person, especially if timely treatment is neglected. The nature and size of spots can be completely different, the same can be said about the timing of their appearance - there are no absolute guarantees after how long the rash will appear.

In this article, we will talk about the stages of syphilis and the skin manifestations characteristic of these stages, in addition, we will learn a little general information about this disease and get acquainted with the methods of its diagnosis.

The causative agent of syphilis is called pale treponema. It is a gram-negative spirochete, which gets its name from the fact that it turns pale pink when using the Romanovsky-Giemsa method.

Syphilis is a chronic systemic venereal disease that affects the skin, mucous membranes, internal organs, bones and the nervous system. On the territory of Russia, the disease was first recorded in 1499. Like most serious pathologies, syphilis has its own classification.

There are the following groups:

• primary;
• secondary (early and late);
• tertiary;
• congenital.

Note! It was found that the early forms of syphilis are more contagious, syphilis can be resolved without a trace. In late forms, the degree of contagiousness is less, however, syphilides are accompanied by irreversible destruction of body parts.

In more extended classifications, syphilis can also be:

• seronegative;
• seropositive;
• fresh;
• hidden;
• recurrent;
• active;
• early or late congenital;
• visceral;
• nervous system;
• fetus.

Cases in which fetal syphilis or congenital syphilis is observed almost always end with the birth of a still child, or the death of the child while still in the womb.

Transmission routes

Almost all known transmission routes are available for this disease, and therefore the incidence of syphilis among the population is steadily increasing.

Known transmission routes include:

1. Sexual- the disease is transmitted by contact with an infected person, the risk of infection is about 50%. Syphilis is transmitted through all types of sexual intercourse.
2. Domestic- occurs in cases where one of the partners is infected, and the second is not aware of this, or neglects the rules of hygiene. Infection occurs through common objects, saliva when kissing.
3. Blood transfusion- cases of infection are observed during blood transfusion of infected with syphilis to a healthy person. However, this is a very rare occurrence, since the donor undergoes a thorough check before donating blood. More often, this route of infection is found among injection drug addicts, when using one syringe.
4. Transplacental- consists in the transmission of syphilis to the child from the mother through the placenta during pregnancy. Leads to congenital syphilis. In addition, infection can occur during breastfeeding or passing through the birth canal.
5. Professional- occurs in medical workers who come into contact with the body fluids of a sick person. A doctor can become infected during surgery if there was damage to the skin in the process.

From the information received, it follows that in order to avoid infection, one should not neglect protection during intercourse, and also use an individual set of dishes and hygiene products when living with a patient with syphilis.

A characteristic rash with syphilis

Spots on the body are an integral part of the manifestations of syphilis. The disease begins with the formation of a primary affect - a hard chancre, which is a hard, painless, deep ulcer.

The chancre is not welded to the surrounding tissues, does not bleed, and does not increase in size. In the future, the course of primary syphilis is not accompanied by any changes in the skin or mucous membranes.

With the development of the disease and its transition to secondary syphilis, spots from syphilis appear about 1-2 weeks after the prodromal symptoms. The rash in this period is characterized by polymorphism and a benign course (they do not destroy the surrounding tissues), the absence of subjective symptoms (sometimes slight itching) and signs of acute inflammation.

With syphilis, the occurrence of syphilitic roseola or spotted syphilis is noted. In this case, the elements are rounded, up to 10 mm in diameter and pale pink. Syphilis spots are localized on the skin of the trunk, arms and legs, in rare cases on the face, feet and palms. The appearance of roseola occurs gradually, about 10 pieces per day, and when you press on them, they disappear.

Papular syphilis is another type of rash, the elements look like tight-elastic papules of pinkish or red color, no more than 5 mm in size. Over time, desquamation begins in the center of the papule, with further spread to the periphery. After resolution, hyperpigmentation is present for a long time at the site of the papule.

Note! A typical sign of syphilis is the presence of "Biett's collar" - peeling along the edges of the papule, when in the center it is already absent.

What are the spots on the body with syphilis in more rare forms of skin manifestations?

This includes pustular syphilis, which appears mainly in debilitated patients and is accompanied by purulent exudate, after which a yellow crust forms. Another manifestation of a rare form of rash is pigmented syphilis, which forms on the back and side surfaces of the neck and has a pitchfork of white spots of a rounded shape. This feature is called the "necklace of Venus".

In tertiary syphilis, tertiary syphilis develops over several years without any sensation or inflammation. Elements of rashes in this period leave behind scars.

Allocate gummy and tuberous syphilis:

• Tuberous syphilides characterized by the formation of infiltrative nodules that protrude above the skin, measuring no more than 7 mm. The nodules are reddish-brown and dense to the touch. The rashes are located asymmetrically, the elements are at different stages of development, but do not merge with each other.

Over time, syphilides necrotize and round ulcers are formed with a clean bottom, smooth edges and an infiltrated base. Syphilis ulcers heal for a long time, leaving behind areas of atrophy or scars with hyperpigmentation around the edges. In the area of ​​scars, repeated rashes never occur.

• Gummy syphilide- usually a single element, which is a node located in the subcutaneous tissue and painless on palpation. Gummas can be located on the forehead, in the area of ​​the elbow or knee joints, on the legs or forearms.

At the first stages, the gum is mobile, but later, due to an increase in size and fusion with surrounding tissues, it loses its mobility. Further, in the center of the node, a hole is formed through which a liquid of a gelatinous nature is separated.

A characteristic feature of gum is the formation of a crater-like pit with a necrotic core at the bottom. After the rod comes off, the ulcer begins to heal with the formation of a retracted stellate scar.

Sometimes there are cases in which the gum does not turn into an ulcer, then the node decreases and is replaced by dense connective tissues. Gummas can form and affect not only the skin and subcutaneous fat layer, but also penetrate into cartilage, tissues, blood vessels and muscles, simultaneously destroying them.

Diagnostics of the manifestations of syphilis

The appearance of any kind of skin rash usually causes anxiety, even if it is a contact allergy and not a serious sexually transmitted disease. In any case, if a rash appears and syphilis is suspected, it is necessary to seek advice from a dermatovenerologist. After that, the diagnostic method will be individually selected and the instructions on how to properly prepare for the study will be explained.

The selection of the research method is carried out on the basis of the history and the existing symptoms:

It is worth noting that the price of some analyzes can be quite high, so you should not engage in self-diagnostics, but it is better to contact a specialist so that he not only directs to the necessary analyzes, but also interprets the results obtained.

From the photos and videos in this article, we managed to learn a little more about syphilis, as well as about all the possible variations of the rash in this disease.

Frequently asked questions to the doctor

Real experiences

Hello. A week ago, I had unprotected intercourse, and a couple of days later I noticed a red rash on my partner's body. Could this be a sign of syphilis, and should I get tested now?

Good day. During syphilis, certain periods are distinguished. The initial one is called primary syphilis. At the stage of primary syphilis, there is a certain period of time, namely, the first 3-4 weeks after infection, when the test results do not reveal the disease. This period is called primary seronegative syphilis.