Secondary syphilis is the second stage of the disease, which begins five months after infection and lasts about five years. This pathology is caused by the spread of infection throughout the body, it affects all organs and systems. The symptoms of the disease are varied, most often a person develops papular syphilis - a rash on the skin and mucous membranes. This manifestation of the disease is observed in 80% of cases.
Description and characteristics of the problem
Papular syphilis (syphilis papulosa) is a frequent manifestation of secondary syphilis on the skin and mucous epithelium of the body. Pathology is a rash in the form of papules or nodes of a round shape and a dense consistency. At first, papules have a smooth surface, over time they begin to peel off, a border is formed along the edge, which is called Bietta's collar. The rash appears in various places, but most often it is localized in the genital area.organs, on the palms and soles. Papular syphilis of the palms and soles is characterized by the presence of hyperkeratosis.
The disease proceeds in waves. In this case, a person does not have itching and pain. Papules are red or purple in color and may spontaneously disappear without leaving a scar.
In secondary syphilis, papules are randomly scattered throughout the body, and papular syphilides are also located in the mouth and in the genital area. In the oral cavity, papules are localized on the tonsils and tongue in the form of erosions and abrasions. In the area of folds, they often get wet and deformed, condylomas may appear in their place.
Papular syphilides are quite contagious, as they contain a large number of pale treponemas.
Causes of disease
Treponema pallidum is the causative agent of syphilis. Infection occurs when it enters the body through the skin or mucous epithelium, the integrity of which is broken. This can happen during intercourse or by contact-household. Often, secondary syphilis is discovered during a random examination or at a time when a person has a tonsil lesion.
Types of pathology
Syphilitic papules can manifest themselves in different ways, varieties and symptoms are presented below:
- The lentil-like type is characterized by the appearance of papules with clear borders of pink with a purple tint, resembling lentils in their appearance and structure. On their surface there is an accumulation of densescales that are difficult to remove.
- Annular papules. In this case, the elements of the rash are grouped into rings or arcs.
- Corneous papules are characterized by the presence of horny layers that resemble corns or warty growths.
- Keratodermia punctatum syphiliticum - white papules up to one centimeter in size, which rise above the surface of the skin and resemble in appearance a millet grain placed in a depression in the skin.
- The wide type is characterized by the presence of papules of different sizes, irregular outlines, which are covered with horny layers.
All of the above papular syphilides are painless, they do not itch or become inflamed. Eruptions tend to be chronic.
What are the types of papular syphilis?
In medicine, there are several types of pathology depending on the size of papules:
- Lenticular, which is caused by the presence of papules of a clear round shape, they are evenly distributed over the skin, not prone to increase in size. The surface of the papules is smooth, with time it begins to peel off. This process begins to spread from the central part of the papule. At first, the rashes are red, and then acquire a brown tint. At the sites of disappearance of papules, age spots are formed. Rashes are observed on the trunk, limbs and even the face. They stay on the skin for several weeks.
- Papular miliary syphilis is of two subspecies. In the first case, these are papulesthe size of a millet grain of copper color and cone shape, on the surface of which peeling is observed, and then pigmentation. In the second case, the papules are flesh-colored, small in size and cone-shaped. In this case, the rash is compared with the so-called goose bumps. Some doctors associate this disease with the presence of active tuberculosis in a person. The lesions are usually located on the trunk. This type of disease is the worst to treat.
- Coin-like or nummular syphilis is characterized by the presence of papules that are the size of a coin. Such rashes indicate a relapse of the disease. The number of papules is small, they can be observed on any part of the body.
- Plaque papular syphilide is large compared to other varieties of papules. Usually such rashes are localized on the genitals, in the anus and in large folds of the skin.
- Seborrheic syphilis is caused by the formation of greasy scales on the face, forehead, scalp.
- Psoriasis, which are highly flaky and localized symmetrically under the armpits, in the popliteal fossae, elbow creases and scalp.
- Erosive syphilis acts as a weeping form of rashes that form on the mucous epithelium and in skin folds. This type of pathology is considered to be the most contagious.
Characteristic of rashes
Papular syphilides have some characteristics:
- First, there is a symmetrical profuse rash, the elements of which are small in size and brightly colored.
- Further, the number of papules decreases, they can be grouped and form bizarre patterns in the form of rings, arcs or garlands.
- With each subsequent relapse, the number of papules decreases. At the end of the second stage of syphilis, the rash may be solitary. This suggests that the disease is moving into the third stage - tertiary syphilis.
Papules have distinctive features:
- sudden education;
- clear contours;
- polymorphism;
- special coloring;
- reactions of surrounding tissues are not observed;
- benign pathology;
- spontaneous disappearance;
- highly contagious.
Pathology during pregnancy
The disease poses a danger to a pregnant woman and her unborn child. According to statistics, in the absence of effective treatment, and also when the pathology is not completely cured, the child will definitely become infected with secondary syphilis from an infected mother during labor.
Also often women do not bear a child with this disease. But when a woman is completely cured of secondary syphilis, undergoes a course of effective therapy, will be constantly monitored by the attending physician, she will have a he althy child who will not have pathologies.
Symptoms and signs
Usually, with secondary syphilis, spotted and papular syphilides often develop simultaneously. If in the second case the papules flake off, then the first form of the pathology is characterizedthe appearance of pink spots without peeling.
The location of the papules affects the manifestation of the symptoms of the disease. Horny papules are usually located on the limbs, in their appearance they resemble corns. They can appear on the toes and between the toes. On those skins that are supplied with a large number of sebaceous glands, in particular on the face, papules are covered with yellow scales, which resembles seborrhea. They can form into rings and arcs. Typically, such rashes are observed with a relapse of the pathology.
Papular syphilis on wet surfaces, such as in the anus or genitals, often transforms into erosion. In this case, the causative agent of the infection comes to the surface of the skin. With friction or mechanical irritation, such papules lead to papillary growths.
Mucus membranes
Pathology also affects the mucous epithelium, erosion and even ulcers form on it. A yellow coating appears on their surface. Constant irritation of papules leads to their growth, they can merge, forming a continuous infiltrate. Usually this phenomenon is observed in the tonsils. In this case, the infectious agent comes to the surface, which significantly increases the risk of transmission of the disease. Rarely, papules are localized on the epithelium of the vagina, cervix. Most often, the mucous membrane of the oral cavity and pharynx is affected. In this case, the rash will have the same appearance as on the skin, but their color will be white.
Often a person develops papular tonsillitisin combination with laryngitis. Roseola and papules form on the mucous epithelium of the epiglottis, vocal cords, which leads to hoarseness and aphonia.
When papules appear in the corners of the mouth and between the fingers, cracks form on their surfaces that cause pain.
Diagnostic measures
Papular syphilides, the diagnosis and treatment of which will be discussed below, can be localized throughout the body. Diagnosis is facilitated by the presence of papules not only on the mucous membranes, but also on the skin. Therefore, the doctor during the examination asks the patient to undress, and then examines his body, especially the genital area and anus.
The doctor then orders lab tests:
- Wassermann reaction.
- ELISA for the detection of STDs and secondary syphilis.
- The reaction of passive hemagglutination in order to identify the stage of pathology.
- Study in a dark field using a microscope to detect microorganisms.
- Precipitation test that detects antibodies to Treponema pallidum.
- Immunofluorescence is done to rule out false test results for syphilis.
Differential Diagnosis
Usually, papular syphilis is differentiated from diseases such as lichen erythematosus and psoriasis, parapsoriasis, skin vasculitis, skin tuberculosis, hemorrhoids, warts, rubella and measles, spotted taxiderma, as well as urticaria pigmentosa, pemphigus, pseudosyphilitic papules.
Thus, differentiation is carried out with those diseases,which manifest themselves in the form of a rash, multiple lesions of the skin and mucous membranes.
Therapy
Having studied what papular syphilides and their varieties are, it is necessary to find out how the pathology is treated. Therapy in this case should be complex and only under medical supervision. Usually, the patient is prescribed antibacterial drugs for a long period (at least twenty-four days). Antibiotics of the penicillin group are used. Doctors say that secondary syphilis responds well to therapy, you only need to follow the doctor's prescriptions and recommendations.
Medicines are used as injections, they are administered intramuscularly every three hours. The doctor also prescribes immunomodulators, biogenic stimulants, vitamin complexes and UVI. Skin rashes are treated with antiseptic solutions or iodine.
Modern clinics often use the "one shot" method of treatment. But this approach is not effective, in addition, it can lead to the opposite effect: the emergence of resistance to antibiotics of the infectious agent.
Forecast
Papular syphilis responds well to therapy, so effective treatment, if it is completely finished, gives positive prognosis. Untimely treatment or its premature termination provokes the transition of the disease to the next stage - tertiary syphilis.
Prevention of pathology
Preventive measures include:
- drug therapy;
- use of contraception;
- urgent treatment of primary syphilis.
To prevent the development of pathology, you need to monitor personal hygiene, use your own household items and toilet. It is recommended to periodically take tests for STDs, undergo examinations with a doctor.
For the purpose of prevention it is necessary:
- have one sexual partner;
- do not have casual sex;
- avoid contact with carriers of infection;
- use your own hygiene products
- get tested periodically for STDs.
When papular syphilides appear, you must immediately contact a medical institution, self-medication is unacceptable.
Conclusion
Papular syphilis is one of the most common symptoms of secondary syphilis. It can have several varieties and forms. This pathology requires immediate therapy, which usually gives positive results. But only in the case when a person will strictly comply with all the prescriptions of the attending physician.
