Primary syphilis is the initial stage of pathology development. In most cases, people miss the early symptoms of the disease because they have no idea about it. But the disease must be able to recognize at an early stage in order to be able to recover from it without the development of serious consequences. One of the manifestations of primary syphilis is the formation of a hard chancre and indurated edema.
Onset of disease
Syphilis begins to show its first signs three weeks after a person is infected. At the place where pale treponema (the causative agent of the disease) entered the body, a spot forms, which in seven days transforms into an ulcer. So there is a hard chancre. A week after this, the lymph nodes located next to the chancre begin to inflame and increase in size. Lymphatic vessels, through which the infection penetrates into the nodes, also increase, indurative edema develops. In medicine, this phenomenon is calledlymphangitis.
Thus, chancre, lymphangitis, and swollen lymph nodes are standard features of primary syphilis.
Description and characteristics of the problem
Indurative edema in syphilis is a form of specific lesion of the lymphatic vessels of the skin, located near the hard chancre, or an independent manifestation of primary syphilis. Most often, this phenomenon is observed in the genital area: in women in the labia and clitoris, in men - on the skin of the scrotum and foreskin.
This pathology is characterized by an increase in the size of the affected area by four times, its tissues become dense and hard. Swelling of the intimate zone occurs due to the abundance of small lymphatic vessels in this area. At the same time, it is painless, the inflammatory process does not develop. Palpation of the edema also does not cause pain to the patient; when pressing on the affected area, the fossa does not remain.
Causes of puffiness
Indurative edema occurs as a result of a violation of the outflow of blood and lymph due to the development of primary syphilis. Such a pathology usually forms around a hard chancre, while the pathological area becomes dense. An infiltrate from a hard chancre spreads beyond it, provoking the appearance of puffiness.
Symptoms of pathology
Itching is usually present with indurative edema. The skin in this area has a dark red color, sometimes a blue tint can be observed. This phenomenon is observed up to two weeks, but without therapy, it can persist until the development of secondary syphilis. In many patients, the pathology is complicated by the addition of a secondary infection. Over time, inductive edema, a photo of which can be found on stands in gynecological or venereological clinics, is joined by polyadenitis, in which there is an increase in lymph nodes throughout the body. The closer the lymph nodes are to the chancre, the larger they are.
Recently, extra-sexual localization of chancre and edema has been encountered, for example, on the skin and mucous membrane of the anus, abdomen or thigh, fingers of the upper extremities, in the oral cavity.
Often the patient's tonsils are enlarged, they acquire a copper tint, they form chancre-amygdalite. In another case, the formation of a chancre on one of the terminal phalanges of the fingers is possible. Suspect syphilis helps swollen lymph nodes and the formation of edema.
Complications
Hard chancre and indurative edema of the labia in women leads to the development of bartholinitis, in men - phimosis, balanitis, gangrenization. On palpation of the skin sweetness of the foreskin, where edema has formed, an infiltrate is determined that does not cause pain. With paraphimosis, this edema contributes to the infringement of the head, which can provoke its necrosis. In this case, the flow of blood and lymph is even more disturbed, and the indurative edema increases. Its borders become fuzzy, the skin becomes cyanotic.
Whennecrosis of the bottom of the chancre develops gangrene, a black scab appears. After it falls off, a tissue defect remains on the affected area. A secondary infection often joins this process.
Diagnostic measures
Diagnosis of primary syphilis is difficult due to the presence of complications. The doctor examines the history of the disease, examines and interviews the patient. The presence of syphilis is indicated by three main signs: hard chancre, indurated edema, and swollen lymph nodes. Laboratory tests are required to make an accurate diagnosis. During the survey, the doctor determines the number of sexual partners and sexual contacts in the last six months.
Laboratory diagnostics
The most important step in determining primary syphilis is a laboratory test. The doctor prescribes the following methods:
- PCR and ELISA;
- dark field microscopy (TFM);
- RMP and RPR.
During the first week of chancre formation, a laboratory blood test may not show the presence of primary syphilis, so a scraping is taken from the chancre and sent for TMT or PCR.
If the chancre is observed for three weeks, then RPR and ELISA tests are used to make a final diagnosis.
Differential Diagnosis
Specific clinical manifestations of primary syphilis makes it possible to reliably differentiate the disease with such pathological changes in the genital area as scabies, tuberculous or gummous ulcer, tumor, chincroid,herpes and others. But it is necessary to conduct laboratory tests.
Therapy
Treatment of swelling of the intimate area and hard chancre should be carried out as early as possible, as these signs indicate the development of a serious disease that poses a danger to the he alth and life of the patient.
The main method of therapy is antibacterial treatment, and it is absolutely impossible to interrupt the course. Pale treponema is sensitive to penicillin drugs, so these antibiotics are used to treat syphilis. Usually the drug is administered every three hours for one day. If the treatment is ineffective, the doctor prescribes other antibacterial drugs. Also in the treatment of syphilis, immunomodulators, vitamin and mineral complexes are used. The course of treatment is about three months.
Periodical blood tests are performed to evaluate the effectiveness of treatment. It is forbidden to have sexual intercourse during therapy. All sexual partners of the patient should be tested for syphilis, and they should also receive prophylactic treatment. Otherwise, the risk of relapse increases several times. Therefore, it is important to inform your sexual partners about the presence of syphilis so that they can get tested in a timely manner.
After the end of therapy, patients should be under medical supervision for one to three years. The control of curability is carried out during the entire observation period using the RPR test.
Forecast and prevention
Primary syphilis responds well to therapy, so effective and timely treatment gives favorable prognosis. In the absence of treatment, complications begin to appear, the disease passes to the next stage of development.
The most reliable method of prevention is the use of barrier contraception. It is also important to undergo a timely examination when in contact with people who are infected. If the first signs of pathology are found, you should immediately visit a doctor and do not forget to inform your sexual partner about the pathology so that he can be examined as soon as possible.
Conclusion
The sooner a person suspects syphilis by the presence of symptoms such as hard chancre, indurated edema and swollen lymph nodes, the easier it will be to cure the disease and less negative consequences and complications will develop. That is why it is important to know what are the first symptoms of syphilis.
Even one ulcer in the genital area or oral cavity should alert a person. If, after some time, edema formed nearby and the lymph node enlarged, it is highly likely that primary syphilis will develop. If you suspect this disease, you do not need to let everything take its course, it is imperative to see a venereologist and undergo the examination prescribed by him. The sooner the treatment of pathology begins, the more favorable its prognosis will be. Must be examined andsexual partner to reduce the risk of recurrence of the pathology in the future. By following all the rules and recommendations, you can avoid serious he alth complications.
