Household syphilis on the lip. What does a syphilitic (hard) chancre look like? Syphilis on the tongue: differences from herpes and candidiasis

When spirochetes have penetrated, for which an insignificant, completely imperceptible violation of the integrity of the skin is enough. After the first incubation period, most often at the end of the second week, a small nodule appears. It very often, but not always, ulcerates. Gradually turns into an extremely dense, cartilaginous hardness infiltrate, which forms the base and edge of the developing ulcer. This phenomenon is called hard chancre in men and women. Photos, the initial stage as the primary signs will be considered in the article.

Symptoms of hard chancre, initial stage

Specific signs of a hard chancre with syphilis are the following moments of changes in the skin. The rash, which is also an infiltrate, is mostly flat, sharply demarcated. To the touch, it gives the impression that there is a hard plaque in the skin. But depending on the location of its localization, the nature of the rash can be very different.

Usually there is only one primary eruption. But relatively often there are several hard chancres. Moreover, they are all in the same stage of development, since they all appear simultaneously depending on the same infection. Further transfers in the same patient from one chancre are not observed, since after infection, immunity to a new infection soon sets in. Moving to another place of the skin, as opposed to a soft chancre, is not observed with this primary sign of syphilis.

Dimensions of hard chancre photo

The size of the hard chancre varies over a very wide range. Its surface can be covered with a thin, moist luster, as if eroded epithelium, which is especially characteristic. When palpated, a cartilaginous density infiltrate is felt. With a more pronounced erosion surface, the skin appears dark red, as if granular. When ulcerated, the ulcer is always smaller than a hard roller, and has a dense base. With ulceration, it may be the case, depending on the method of formation:

1. With ulcerated sclerosis.
2. With sclerosed ulceration.

In the latter case, the situation may be different. First, a very small nodule formed at the site of infection can turn into a vesicle and an ulcer before the actual syphilitic infiltrate is detected.

On the other hand, an existing vesicle, especially the vesicle, can serve as a site of entry for spirochetes, which is relatively common. In this case, an ulcer quickly forms.

How hard chancre begins photo

The most important role in the origin of infiltrating, sclerosing ulcers plays. It may have existed prior to the infection with syphilis or was acquired at the same time as it. With this simultaneous infection: a soft and hard chancre, which is not uncommon, a soft chancre develops first. It has a much shorter incubation period of only a few days. Hardening, as a result of simultaneous infection with syphilis, is detected after 2-3 weeks. The base and circumference of the soft ulcer are compacted: a "mixed chancre" (chancre mixte) is obtained.

Not only that, a chancre ulcer may heal before a lump develops. "Mixed chancre" deserves special attention. Namely, it must be remembered that with the presence of a soft chancre ulcer, the possibility of simultaneous infection with syphilis cannot be ruled out before the expiration of several weeks.

Stages of hard chancre in men and women

Ulcerative sclerosis, that is, a successively decaying syphilitic infiltrate, can lead to the formation of:

• then flat,
• sometimes deep or crater-like,
• either smooth or having a pitted bottom,
• then a gangrenous or serpiginous ulcer.

It is only important to remember that a hard chancre ulcer is never so sharply delimited and such a regular round shape as a soft chancre ulcer. And that it always has a hard bottom and a hard roller. It is also characteristic that on the edge surrounding the ulcer, a very narrow strip always appears red, eroded, devoid of epithelium.

What does a hard chancre look like, a photo in women and men with syphilis

Depending on the location, the chancre may present some differences. So, when localized in the coronal sulcus, sclerosis often appears as a dense roller, sometimes running parallel to the entire length of the sulcus. Often this results in phimosis or paraphimosis. Sclerosis, hidden by phimosis, is felt by palpation mostly in the form of limited hardening.

Of the mucous membranes, the site of sclerosis is mainly:

All mucosal scleroses quickly disintegrate into deep, crater-like ulcers with a dense bottom and ridge. Each place of the skin and visible mucous membranes can be the site of localization of primary sclerosis.

Hard chancre on the penis and on the head photo

If sclerosis sits on the edge of the foreskin, then ulceration is formed in the form of a crack on a dense ring perpendicular to the opening of the preputial sac.

A particularly peculiar picture is obtained when, as a consistent condition, a significant, diffuse inflammatory swelling appears on the genital organ.

Then the penis takes on a completely shapeless appearance and appears to be testy-edematous to the touch (indurated edema).

A similar condition occurs on the vulva.

Hard chancre on the labia photo:

Hard chancre photo on the arm

If sclerosis sits on the finger, then the primary lesion often has the appearance of paronychia or panaritium; recognition can be extremely difficult.

Syphilis hard chancre on the lip photo

Often, primary sclerosis occurs on the lip and on the nipple, where it forms a dense, limited, eroded and ulcerated tumor.

The most important sign of every syphilitic primary manifestation is, without a doubt, the presence of spirochetes.

In fact, contracting syphilis is easy and does not require a close relationship with a sick person. For a long time, pale treponema is able to live in a humid environment, which is why it can enter the body in a domestic way.

Syphilis on the lip is a rather dangerous disease. Of all sexually transmitted pathologies, this is considered the most unpleasant. The mucosa in the oral cavity is more susceptible to syphilitic infection. How the disease develops and whether it can be treated, we will consider below.

Syphilis is an infectious disease, its main causative agent is bacteria, namely, Treponema pale. Pathology manifests itself in several stages, while with each of them the human condition may worsen. During the transition between stages, a period of remission may occur, unpleasant symptoms recede, and a feeling of relief arises. But in fact, not everything is as good as it might seem.

The disease can develop not only due to the fact that a person is sexually promiscuous. Medical workers are also susceptible to pathology, as they can directly contact patients.

The disease is dangerous because it is completely impossible to get rid of it. If treatment is not available, there may be quite serious consequences. In some cases, pathology can lead to the death of a person.

Both men and women are equally affected. The main peak of infection falls on the period when people are from 18 to 45 years old. There are two forms of syphilis development: acquired and congenital.

In the second case, the child becomes infected from the mother, being in her stomach, the bacteria penetrate the placenta. In the first case, it is enough to use the personal items of a sick person, to touch his mucous membrane.

Interesting! On the lip, a hard chancre does not appear immediately. The latent stage can last up to six months. During this time, a person will be potentially dangerous to others, while he may not be aware of his illness.

Reasons for the development of the disease

There are many reasons for the development of the disease. The main way treponema enters the body of a healthy person is through sexual contact with a sick person. A rash on the lips can occur after kissing a sick person or after oral sex.

Medical instruments that have not been processed enough can also become a source of infection. Even a dentist can "catch" an infection.

The following can be attributed to provoking factors:

• wounds, cracks, scratches on the mucous membrane and skin;
• infection can occur during injections, as well as during surgery;
• professional activity.

Even small abrasions on the skin can lead to infection. When bacteria and blood come into contact, the probability of their penetration is almost 100 percent.

Surgery can cause infection. The thing is that medical instruments are not sterile enough. Several decades ago, bacteria entered the human body during a blood transfusion, but now this practically does not happen, since all safety measures are observed.

Doctors are at risk, as they are constantly in contact with sick people. Even elementary precautions cannot guarantee complete safety.

Among healthcare workers, the following causes of infection may be:

• surgical intervention;
• carrying out therapeutic measures;
• during blood transfusion;
• after the opening of the abscess.

Due to the high likelihood of infection, all medical personnel must carefully monitor hygiene. Sterile gloves should be disposable.

When using household items, infection can also occur. For a long time, the pathogen can live outside the human body, the main thing is that there is a suitable environment for this. The risk of infection increases when visiting swimming pools, saunas, baths and other public places.

Among household sources of infection, the following can be distinguished:

• sitting on shared toilets;
• tableware;
• towels.

Pregnant women should be especially careful, as their immunity during this period is greatly weakened. The photo below is an example of the development of syphilis on the lip.

Symptoms of syphilis

The symptoms that appear during the development of the disease can be different, it all depends on what stage it is at.

Several stages can be distinguished:

• first- the chancre begins to appear;
• second- rashes from the lips move to other parts of the body;
• third- the appearance of gums.

The chancre appears in the place where the pathogen was in contact with the mucous membrane. After the initial occurrence, the rash is round in shape, its color is red, and on palpation, you can feel a seal. The size of the spots does not exceed two centimeters.

In relation to the edges, it seems that the center is slightly deepened. Important! Since chancre rarely causes concern, many patients do not seek help from a medical facility in a timely manner.

In the second stage of the disease, roseola begins to appear. Spots of red color are constantly growing, after which they can merge together. Diffuse erythematous stomatitis may occur. There is no pain whatsoever. Interesting! There are quite a lot of treponemas in the spots. This stage is a secondary manifestation of syphilis.

The video in this article goes into more detail about how the symptoms of the disease appear.

If the patient does not go to a medical facility, the disease will go into a latent form, but after some time an exacerbation may begin. In this case, the spots no longer appear, large papules form in their place, gradually they develop into plaques.

Localized in chains, peeling along the edges. At this stage of development, bubbles may appear inside which pus. In this case, the lymph nodes on the body may increase, the body temperature rises.

At this stage of the development of the disease, the patient is potentially dangerous to others. Treatment and hospitalization is a must. In the absence of therapy, syphilis from the lips can move to the throat.

At the tertiary stage of development, gummas appear. However, this phenomenon is possible only when the disease is in advanced form. The period of gum development is up to five months. Outwardly, these are small ulcers with seals. Due to the atrophic scar, there is a strong deformation of the oral cavity.

During the decay of gums, diffuse sclerotic glossitis is formed. It is difficult for patients to speak, the tongue seems to become wooden. Even after complete recovery, defects do not disappear; they can only be eliminated by prosthetics and plastic surgery.

Important! On the lip, syphilis can appear a month or six months after infection.

After the initial appearance of the disease, the lymphatic and submandibular nodes increase in size, but the symptom does not last long, disappears on its own after a month. The disease continues to develop further. Within a few months, syphilomas will penetrate the bloodstream, resulting in rashes appearing all over the body.

The patient may experience the following symptoms:

• body temperature rises;
• general well-being worsens;
• feeling of ache in the joints;
• lack of appetite;
• severe headaches.

It is important to differentiate the disease from other possible pathologies, for example, fistula, tonsillitis, purulent tonsillitis, and so on.

Diagnostics

Before starting treatment, it is necessary to undergo a complete examination, in most cases it takes place according to the standard scheme. The first and main stage is a timely visit to the doctor. During this period, the doctor can make a preliminary diagnosis.

After that, the anamnesis begins to be studied:

• patient complaints;
• information about sexual activity;
• Have you had sexually transmitted diseases before?

After the interview, it is necessary to conduct a clinical examination, the affected area should be carefully examined. The lymph nodes are palpated without fail. But all this is not enough to make an accurate diagnosis.

Laboratory diagnostics is used:

• reaction to the development of treponema;
• Wasserman reaction;
• examination for immune fluorescence.

It is necessary to study the clinical picture of the patient. Examines the chancre in order to distinguish it from:

• development of a cancerous tumor;
• pyoderma;
• ulcers after injury;
• herpes erosions.

It is not difficult to distinguish a chancre from other pathologies; this can be done based on some factors:

1. With ulcers after injuries, there are no seals.
2. With erosion from herpes, pain and swelling appear. The course of the disease is rapid, vesicles form within a few days.
3. Pyoderma causes inflammation. There are discharges of a purulent nature, the course of the disease is long.
4. Syphilis in its symptoms can resemble a cancerous tumor. However, the difference is that the infiltrate is much deeper than the chancre.

When conducting an examination, it is important to identify the causative agent of the disease. Due to the unstable clinical picture, it is difficult to detect pathology at the first stage. There is no pain, which is why few patients go to the hospital for help.

A scraping is taken from the papules, if after the examination a pathogen was found in it, then a diagnosis can be made without difficulty. Another important diagnostic method is a serological test. With a positive result, a diagnosis of syphilis is made.

Treatment Methods

The main indicator of correct treatment is a change in the amount of antibodies. If the therapy is chosen correctly and was carried out in a timely manner, then the concentration of lgM decreases sharply. As for lgG, there will be no changes here.

Based on these indicators, we can conclude that immunity becomes stable, the infection becomes not as active as it was before. For a long time, antibodies can stay in the human body for a long time. The next few years after treatment, the result may show a positive result.

The disease is treated by a venereologist. It is worth noting that in no case should you self-medicate. Antibiotics are used for therapy. Depending on the stage of development of the disease, the drugs can be taken continuously or in courses.

Instructions for taking them are determined by the doctor, depending on some factors:

• how much does the patient weigh;
• the presence of concomitant pathologies;
• what is the response from the immune system.

Not only antibiotics are prescribed, but also immunomodulators, as well as vitamin complexes. A certain percentage of patients are registered in a dermatovenerological institution. After a certain time, the patient is removed from the register.

The most popular drugs for treatment:

Syphilis must be treated fully. Human immunity at the time of therapy is greatly weakened, problems with the endocrine system may occur.

Immunomodulators are mandatory, for example, Immunoglobulin. The number and duration of injections is determined by a specialist.

Prevention

The main route of infection with syphilis is sexual, in connection with this, the following preventive measures can be distinguished:

• it is necessary to observe the rules of personal hygiene;
• the use of contraceptives, namely condoms;
• You can't have casual sex.

Not only the patient, but also the doctor treating him should take precautions:

• when examining a patient, disposable gloves should be used;
• medical instruments should be thoroughly sterilized;
• during the procedures, traumatization of the skin should not be allowed.

When visiting some public places, you should use only your own household items, you need to sit on a closed surface. If there is no confidence in the reputation of some places, then you should not visit them.

Syphilis on the lip can cause the development of many complications. At the first suspicion of the occurrence of the disease, it is necessary to consult a doctor as soon as possible. An accurate diagnosis can be made based on the results of the examination. Self-treatment should not be allowed.

Frequently asked questions to the doctor

Incubation period

When to expect the first symptoms of the disease after contact with a sick person?

In each case, the duration of the incubation period is different, but according to statistics, on average, this period is about a month. But it is worth noting that the period of time can be about six months.

An infectious disease on the lips caused by pale treponema is called. This is one of the most dangerous venereal diseases. The delicate oral mucosa is very sensitive to external stimuli and is easily affected by syphilis. It is necessary to contact a specialist in time to avoid the spread of infection to healthy tissues and organs.

Unconditional carriers of the infection are people who are promiscuous. The disease can be transmitted not only through the genitals, but also through kissing and oral sex.

The disease can also manifest itself in healthcare workers. They come into direct contact with infected people during their therapy, blood transfusions, operations, opening abscesses, as a result of the careless use of a medical instrument.

If hygiene rules are not followed by ordinary people in everyday situations, there is also a risk of contracting syphilis. In public places (saunas, baths and swimming pools) you can not use common hygiene items. Everyone should have individual shoes, a comb, a towel, and so on. Hands should be washed after every visit to the toilet and before eating. In this case, you need to make it a rule not to touch your face once again with dirty hands, so as not to bring possible infection through microcracks and pimples.

Is it true that the main cause of sexually transmitted diseases is poor hygiene?

YesNot

The causes of syphilis on the lips are:

• Violation of the integral layer of the lips. It can be small scratches, wounds, microcracks, pimples, abrasions. It is through these pathways that infection occurs. Therefore, with noticeable cracks, they must be lubricated with special pharmaceutical products in order to accelerate healing.
• Unsuccessful operation. The pathogen can enter the blood after an inaccurate injection. Most often occurs due to medical error.
• intrauterine infection. When a child passes through the birth canal of an infected mother, a rupture of her birth canal may occur. In this case, the infection inevitably enters the body of the newborn.

Signs of syphilis on the lips

Signs of infection and manifestations of syphilis on the lips do not occur immediately. The infection goes through an incubation period at the site of localization and the patient may not notice any symptoms from a crescent to 6 months. A person can live during this period with an illness and not know about its existence, while infecting others.

1. The beginning of the manifestation of the disease is considered to be the development on the mucous membrane of the mouth, tongue or border of the lips of a fairly hard chancre, in other words, primary syphiloma. At the same time, the submandibular and lymph nodes noticeably increase in size. These signs appear for an insignificant time period, and literally disappear after one month. Therefore, many patients do not pay any attention to them.
2. After 2 months, the disease worsens. The infection penetrates into the bloodstream and causes characteristic rashes on the mucous membranes and skin. Very often, rashes look like ulcers. At the last stage of syphilis, the internal organs and the central nervous system are affected.
3. During the period of hard chancre, rashes and ulcers, the patient may receive complaints of the following nature:

• aches in the bones;

• loss of appetite.

Expert opinion

Artem Sergeevich Rakov, venereologist, more than 10 years of experience

Very often, signs of syphilis on the lips are confused with purulent tonsillitis, fistula, tonsillitis. To make an accurate diagnosis, it is necessary to conduct a differential diagnosis:

• test for pale treponema;
• Wasserman reaction;
• treponema immobilization;
• immune fluorescence.

As for the stages, syphilis on the lip behaves as follows:

1. At the first stage of the development of the disease, it can be confused with incipient herpes. It is important to know that with syphilis, swelling and blisters do not occur on the lips, as with herpes.
2. Chancre (syphilis on the lip) may resemble pyoderma, but only with it a person is disturbed by severe pain at the site of localization and purulent discharge. There were cases that it was not syphilis that was diagnosed. Chancre is important to differentiate from cancer, which affects the lips very deeply and seriously.
3. At the second stage of syphilis on the lips, it is possible to diagnose a scraping taken from papules and establish a serological reaction.
4. At the third stage of the disease, syphilitic gummas can be distinguished from aphthous stomatitis, tuberculous and traumatic ulcers.

Treatment

Treatment of syphilis on the lips is a very laborious process. Requires therapy in a specialized dispensary. Treatment will be more successful in the first stage of syphilis. In addition, at the initial stage of infection, subsequent complications can be prevented, often leading to the destruction of the nasopharyngeal mucosa.

The causative agent of syphilis is very difficult to influence. Only with the help of antibacterial drugs of the penicillin series, it is possible to contribute to the inhibition of the activity of pale treponema. In the last stages of the disease, bismuth preparations are used.

1. Preparations. Without fail, the patient must use the following medicines: immunomodulators, vitamins, enzymes.
2. Physiotherapy procedures. When the infection passes into the nasopharynx, various methods of washing it are used. The most effective solution is considered to contain 0.5% chlorhexidine and chlorophyllipt, as well as 0.1% sodium bicarbonate, soda and manganese. All components must be mixed in equal proportions.
3. Oil sprays used to stabilize the acid-base balance and prevent thinning and bleeding of the pharynx. Inhalations based on essential oils work well. Esters of neroli, eucalyptus, ylang-ylang and fir are considered the most effective.

Of course, the likelihood of being affected by the disease of syphilis with its subsequent manifestation in the form of growths on the lips is high in people with reduced immune resistance.

Prevention

• It is important to increase your immunity through the correct daily routine and normalized diet.
• You need to walk more often and take walks in the fresh air.
• Addictions such as smoking and alcohol should be eliminated from your life.
• With healthy sleep, nutrition and sufficient physical activity, the likelihood of infection penetrating deep into the body is significantly reduced.

An infected person must constantly observe preventive measures in order to prevent infection of others. Syphilis on the lip can easily be transmitted not only sexually, but also through everyday life. It is important to monitor the hygiene of your body and use personal items (towel, razor, toothbrush) at the same time.

Video

You can also watch a video where they will explain to you how to cure syphilis on the lips.

Syphilis on the lips is not only not a pleasant aesthetic problem, but also a rather dangerous disease that requires prompt treatment. In order not to confuse syphilis with other unpleasant diseases, you first need to undergo a complete diagnosis in the hospital. The doctor will prescribe the necessary tests and, based on them, prescribe an adequate and effective treatment. It is important not to delay the visit to a specialist in order to avoid unpleasant consequences in the future.

Syphilis in the mouth causes many inconveniences. The causative agent of the disease is pale treponema, which enters the oral cavity here and the first signs of infection appear.

Without treatment, a sexually transmitted disease spreads rapidly and can cause disability and death of the patient. The article will consider what causes the infection, how syphilis manifests itself in the oral cavity, is diagnosed and treated.

The reasons

Syphilis on the tongue and oral mucosa can be congenital or acquired.

In the first case, infection occurs vertically from mother to child. The fetus becomes infected during pregnancy when Treponema pallidum crosses the placenta. Infection is possible during the passage of the child through the birth canal and during breastfeeding.

Depending on the period at which infection occurred, venereal disease can cause abnormalities in the fetus that are incompatible with life, but it happens that the newborn does not have severe pathologies.

Acquired syphilis on lips and mouth:

• household way, when pale treponema enters the body of a healthy person through common household items with the patient: dishes, a toothbrush;
• sexually, when the pathogen enters the oral cavity during oral sex;
• by blood contact, when pale treponema enters the body during injections and surgical intervention, with blood transfusion.

It happens that the cause of infection in the oral cavity is associated with the use of non-sterile medical instruments by dentists and otolaryngologists.

Clinical picture

There are several stages of infection, depending on which the signs of the disease differ:

1. incubation period. During it is absent. On average, it lasts 3-4 weeks. But it can be reduced to 14 days, for example, if the patient has other sexually transmitted diseases or pale treponema has entered the body in several places at once. It is possible to lengthen the incubation period up to six months. This is possible in the elderly, in patients with reduced immunity or individual body resistance to pale treponema, when treated with antibiotics.
2. primary syphilis. It lasts from 1.5 to 2 months. At the same time, in the first month it is not always possible to detect pale treponema using laboratory methods, even if the patient has signs of infection. Sometimes the disease helps to identify PCR. The first characteristic sign of a sexually transmitted disease is a hard chancre that appears at the site of penetration of pale treponema into the body. It is a small tubercle with an ulceration in the center, which is red in color. A hard chancre does not hurt or become inflamed, but it can interfere with chewing food and talking. Its dimensions can vary from 1 mm to 2 cm. Hard chancre can be located on the lips, gums, tongue, inner surface of the cheeks, in the throat. To determine syphilis in oneself, it is not enough just to look at the photo, since a venereal infection can resemble herpes, "jamming" in the corners of the lips, sores on the tongue, catarrhal stomatitis. In addition to primary syphiloma, the patient has enlarged regional lymph nodes, which are located on the neck, nape and under the lower jaw. They become dense to the touch, but, as a rule, do not cause pain.
3. Secondary syphilis. It lasts up to 5 years and has an undulating course. During this period, signs of infection appear and disappear. The patient can be replaced. Macular syphilides appear on the mucosa, which are red spots with clear boundaries. They are of various sizes and can merge with each other. Burning and pain in the mouth with syphilis usually does not happen.
4. Tertiary syphilis. This is the last period of the disease, lasting 8-9 years, in which irreversible damage to internal organs occurs. Gummas appear on the mucous membranes and skin, their size can reach 15 mm. After some time, the neoplasm breaks through and painful ulcers appear in their place, which take a long time to heal. Often after them, scars remain on the skin and mucous membranes. One of the characteristic signs of syphilis of the tongue is glossitis, due to which the organ increases in size, its density changes, all papillae disappear from its surface. As a result, its function is disturbed, the patient has problems with speech. Pale treponema affects the internal organs, including the brain, which is why a person develops dementia.

Diagnostics

In making a diagnosis, the doctor is assisted by the collection of patient complaints and laboratory research methods. To exclude other pathologies, the Wasserman reaction is prescribed, but unfortunately, it can be false positive.

If it is positive, then a PCR study of scrapings from ulcerations in the oral cavity is prescribed, and it is studied under a microscope.

It is problematic to identify the disease if it is asymptomatic or the patient has a late stage of infection, in this case, despite the fact that the person has signs of syphilis, serological blood tests are negative. And to make a diagnosis, use PCR diagnostics.

Complications

Without treatment, a sexually transmitted infection will lead to disability and death. All organs are involved in the pathological process, the disease can cause damage:

• the brain, which will lead to paralysis, mental disorder, dementia;
• retinas of the eyes, as a result, the patient may go blind;
• cardiovascular system, which is manifested by rupture of large blood vessels, myocardial damage;
• bones.

Severe complications can be prevented if adequate therapy is carried out in a timely manner.

Treatment

Treatment of venereal disease should be carried out in a hospital setting. Its purpose is to suppress the activity of pale treponema. The causative agent is sensitive to antibiotics of the penicillin series. When for some reason they cannot be used, they are prescribed:

• macrolides;
• tetracyclines;
• cephalosporins.

After the patient has been treated with antibiotics and laboratory methods for diagnosing syphilis are negative, dental procedures can be performed.

If the soft tissues of the oral cavity are damaged and the teeth are loosened, then you need to undergo therapy with a periodontist. When it was not possible to save the teeth, then you can resort to implantation and prosthetics.

Prevention

To prevent the appearance of signs of a sexually transmitted disease, the following recommendations must be observed:

• do not use someone else's dishes and personal items, such as a toothbrush, razor, lipstick, etc.;
• in case of casual sexual relations it is necessary to use a condom, including during oral-genital contact;
• pregnant women are advised to register with a gynecologist as early as possible, undergo tests prescribed by a doctor and, if necessary, undergo therapy.

Conclusion

At an early stage, syphilis in the oral cavity responds well to treatment, so if signs of the disease appear, you should not postpone a visit to the doctor.

The manifestations of syphilis are diverse and numerous. When the disease affects the mucous membranes and skin, bones, joints, internal organs and the nervous system. The disease proceeds in waves, periods of exacerbations (relapses) are replaced by a latent (latent) period. Manifestations of syphilis on the skin and mucous membranes, even without treatment, disappear spontaneously, but then reappear, changing their color.

Syphilis on the lips manifests itself in the form of syphilitic seizures, papular syphilides and gums.

Syphilis on the face manifests itself in the form of a hard chancre, spotted, papular, vesicular and pustular rash in the secondary period, in the form of gum and gummous infiltration in the tertiary period.

Nasal syphilis develops during late congenital syphilis and in the tertiary period. Cartilage and bone structures of the organ are destroyed. As a result of the disease, the appearance of the patient is disfigured, breathing, swallowing and phonation are disturbed. Syphilis of the scalp manifests itself in the secondary and tertiary periods of the disease in the form of a papular-pustular rash, alopecia (hair loss) and gummous infiltration.

Rice. 1. Syphilis on the face - gummy syphilis of the tertiary period of the disease.

Manifestations of syphilis in the primary period of the disease

At the end of the incubation period, primary syphiloma appears at the site of introduction (hard chancre, hard ulcer). More often single (in 60 - 90% of cases).

Chancre in the form of erosion has a smooth bottom, gentle edges and clear boundaries. The infiltrate at its base is poorly expressed, which is why the primary syphiloma is hardly noticeable during examination.

Hard ulcerative chancre with syphilis, it has a solid infiltrate at the base, for which it was called a "hard" ulcer or hard chancre. With a deep ulcer, the infiltrate at the base is powerful, has a cartilage-like structure, the bottom of such ulcers is dirty yellow, often with small hemorrhages, and the discharge from the ulcers is plentiful. When localized in open areas of the skin, hard chancres quickly dry out, become covered with a crust and become similar to pyodermic (pustular) elements. When localized in the corners of the mouth, a hard chancre resembles a crack.

Rice. 2. The photo shows a hard chancre on the lips.

Manifestations of syphilis in the secondary period of the disease

The rash on the face and scalp looks like roseola (spots), papules, vesicles and pustules. In the primary (fresh) rash, it is abundant, brightly colored, often symmetrical. With secondary recurrent syphilis, the rash is not plentiful. At the end of the secondary period, secondary syphilomas may be single.

Features of a rash on the face:

• high prevalence,
• sudden appearance,
• polymorphism (different types of rashes),
• clear boundaries,
• lack of reaction of surrounding tissues,
• lack of subjective sensations,
• high contagion,
• benign flow.

Rice. 3. Syphilis on the face - papular syphilis of the face.

Manifestations of syphilis in the tertiary period of the disease

Gummas and tubercular syphilides are the most common manifestations. They appear on the skin of the face and scalp, mucous membranes of the oral cavity of the pharynx and larynx, mucous membrane, cartilage and bone structures of the nose. The disease is characterized by a severe course.

In the case of gumma appears immediately after the secondary period. With insufficiently effective treatment, tertiary syphilis on the face manifests itself after a latent (latent) period, the duration of which is years and decades. The gums compress and, when disintegrated, destroy the organs in the places of their localization, disrupting their function and disfiguring the appearance of a person. The disease often leads the patient to disability and even death.

The rash is often solitary and virtually non-contagious. Without treatment, they heal for a long time (within 4-6 months). In place of syphilides, retracted, star-shaped, disfiguring scars remain. Under the influence of specific treatment, gumma and tubercular syphilide heals quickly.

Rice. 4. In the photo, the complete destruction of the cartilage of the nose with syphilis.

Nasal syphilis occurs at different periods of the disease.

Nasal involvement in early congenital syphilis

With early congenital syphilis, the nose is affected in 75% of cases. The disease manifests itself either immediately after birth, or during the first 4 to 5 weeks of a child's life. Dry coryza, accompanied by a noisy exhalation and inhalation, is quickly replaced by severe rhinitis. The child begins to sniff, snort and sneeze, refuses the breast. The mucosa at the entrance to the nose is hyperemic, thickened and covered with crusts. A viscous secret is released from the nasal passages. Due to the development of the ulcerative process, blood appears in the secretions over time. In epidemiological terms, children during this period become extremely dangerous to others.

Sometimes newborns develop gummous infiltration in the nose. The decay of the gums is accompanied by damage to the bone structures, as a result of which the perforation of the nasal septum develops, various types of retraction of the external nose are formed.

Syphilitic rhinitis of newborns must be distinguished from gonorrhea and nasal diphtheria. Persistent runny nose, thick nasal discharge, crusting, skin rash, and enlargement of the spleen are factors that point to a specific process.

Rice. 5. Diffuse skin infiltration of Gohzinger and syphilitic rhinitis of the newborn.

Nasal involvement in late congenital syphilis

Nasal involvement in late congenital syphilis develops 5 or more years after birth. In foreign literature, cases of the development of pathology in the 23-28th year of a person's life are described.

Isolation of a viscous secret, the formation of crusts, a feeling of dryness in the nose and throat, loss of smell and the appearance of pain in the nose, forehead and eye sockets are the main manifestations of syphilitic congenital rhinitis in late congenital syphilis. As a result of tuberculous infiltration, the mucosa grows, gradually obturating the nasal passage.

The process often proceeds according to the type of tertiary syphilis. Gummas are located on the nasal mucosa, in cartilage and bone, while the mucosa is involved in the pathological process for the second time. The nasal passages are overgrown, the wings of the nose, its back, tip, shells, bottom and nasal septum are destroyed. Retraction of the nose is a pathogomonic symptom of late congenital syphilis. The nose may be saddle-shaped ("saddle nose"), or be like a bulldog's nose, or have a lorgnette-like appearance.

Syphilis of the nose in the primary period of the disease

The defeat of the nose in the primary period of the disease is rare. A hard chancre often appears on the wings of the nose, at the entrance to its cavity on the skin in the area of ​​the septum. The chancre has the appearance of a red erosion with a roller-like thickening along the periphery, a greasy coating is determined at the bottom, and a dense infiltrate is palpated at the base.

Syphilis of the nose in the secondary period of the disease

Nasal syphilis in the secondary period of the disease develops 6-7 weeks after the appearance of a hard chancre and manifests itself in the form of roseola (erythema) or papules. Erythema (redness) extends to the mucous membrane, which swells and begins to produce a secret of a mucous or bloody-serous nature. A little later, papules appear, which are located on the skin at the entrance to the nasal cavity. Due to constant irritation, the papules erode and the healing process is delayed.

Syphilis of the nose in the tertiary period of the disease

The nose is most often affected in the tertiary period of the disease. The lesion affects the mucous membrane, periosteum, bone and cartilage, where gummas with decay or diffuse infiltrates develop. Destroyed areas of bone tissue are sequestered and come out with pus. The decay of gumma is accompanied by a putrid odor. The gumma itself acquires a bluish-red color and is covered with purulent-bloody crusts. Removal of crusts often leads to bleeding.

The bony septum and floor of the nose are the most frequently affected areas. When they are destroyed, communication with the oral cavity and nasal passages occurs. The nasal passages narrow. The patient is concerned about severe pain in the nose, eye sockets and forehead.

Gummas can form in cartilage and bone, while the mucosa is involved in the pathological process for the second time. The nasal passages are overgrown, the wings of the nose, its back, tip, shells, bottom and nasal septum are destroyed, the nose sinks and takes the form of a saddle ("saddle nose"). The act of breathing, swallowing and phonation is disturbed.

Patients with a gummous process in the nose during the period of tertiary syphilis are practically not dangerous to others in epidemiological terms.

Gumma in the nose should be distinguished from tuberculosis and a malignant tumor. Large deformities of the external nose after treatment are corrected with rhinoplasty.

Rice. 6. Forming gumma of the nose.

Rice. 7. Hummous lesions of the wings of the nose.

Rice. 8. Syphilis of the nose in the tertiary period of the disease - perforation (destruction) of the nasal septum.

Rice. 9. Retraction of the nose is a pathogomonic symptom of late congenital and tertiary syphilis.

Rice. 10. Syphilis of the nose. Destruction of the gummous process of the structures of the external nose.

Rice. 11. Syphilis of the nose. Tertiary period of the disease. Destruction of all structures of the external nose, its septum, bottom, anterior part of the alveolar processes, teeth and upper lip.

Rice. 12. Complete destruction of all structures of the nose.

Rice. 13. During the decay of the gumma and the destruction of the bone between the nasal septa, the nasal cavity and the oral cavity, perforations occur, which makes it difficult for patients to eat, phonation and the act of swallowing.

Syphilis on the lips

congenital syphilis

With early congenital syphilis around the lips and chin, sometimes diffuse thickening of the skin (diffuse infiltration of the Gochsinger skin) is noted on the scalp of the newborn. At the heart of the development of pathology is the defeat of small vessels. The disease begins with the development of hyperemia (redness). Further, the areas of the skin are compacted and smoothed. Lips swell and turn yellow. Hair falls out on the head and eyebrows. The skin becomes thinner and torn. The resulting cracks cause severe pain. They bleed and crust over. The process extends to the red border of the lips. During this period, the child is extremely contagious to others. After 2 - 3 months, a cure occurs. Radial scars form around the lips.

Rice. 14. Syphilis on the face of a newborn - diffuse infiltration of the skin of Gohzinger.

Rice. 15. Consequences of congenital syphilis - Robinson-Fournier scars (radial scars around the lips).

Syphilis on the lips in the primary period of the disease

The cause of syphilis on the lips is the transmission of infection during perverted sex. A hard chancre on the lips appears at the sites of penetration of pale treponemas - more often on the red border of the lips, always solitary, located on a dense base, manifests itself as an erosive or ulcerative syphilide, covered with a dense crust or gray coating, with its hypertrophy painful cracks appear. Hard chancre is highly contagious.

With the localization of a hard chancre in the corners of the mouth, the affected area resembles a jam. At the same time, primary syphiloma is clearly visible with a wide open mouth.

Rice. 16. Syphilis on the lip. primary period of the disease. Hard chancres are located on the mucous membrane of the lips. In the photo on the right, the ulcer is covered with a gray coating. There is no reaction of surrounding tissues.

Rice. 17. Hard chancre on the lips. The ulcerative defect is located on the red border of the lips (photo on the left) and the mucous membrane of the lips (photo on the right). Primary syphilides are covered with a crust.

Rice. 18. Syphilis on the lips. The photo clearly shows the sealing roller around the periphery.

Syphilis on the lips in the secondary period of the disease

In the secondary period of syphilis, papular syphilis appears more often on the lips. Its main localization is the line of closing of the teeth, soft and hard palate. Sometimes papules are located in the corners of the mouth. They are covered with crusts and often crack. In appearance, they resemble jams.

Rice. 19. Syphilis on the lips. Papular syphilis at the corners of the mouth.

Syphilis on the lips in the tertiary period of the disease

Gummas and tubercular syphilides in the tertiary period of the disease may appear on the lips. Due to the pronounced edema, the lip increases significantly in size, acquires a purple-red color. The process proceeds without a pronounced pain syndrome. Ulcerative infiltrate is quite dense, has a red-brown color. Until the moment of ulceration, gumma often resembles, after the appearance of an ulcer, the inflammatory process resembles lip cancer. A distinctive feature of gummous lesions of the lips is the absence of regional lymphadenitis, the absence or detection of single pale treponema in the discharge and a quick (within a month) cure with scarring.

Rice. 20. Hummous lesion of the lip outwardly resembles a hard chancre. The photo shows primary syphiloma before treatment (photo on the left) and 2 weeks after specific treatment.

The skin of the face is affected in all periods of syphilis.

Syphilis on the face in the primary period of the disease

Primary syphilomas (hard chancres) on the face look like ulcers and erosions. They are bright red in color, painless on palpation, with a smooth bottom, a raised and compacted edge. In persons with reduced immunity, there is an abundant purulent discharge and small hemorrhages at the bottom.

Rice. 21. Syphilis on the face - hard chancre in the chin.

Rice. 22. Manifestations of syphilis on the face. Hard chancre on the upper eyelid.

Syphilis on the face in the secondary period of the disease

Papular syphilide of the face

In the secondary period of syphilis, papular syphilis appears on the face. Papules on the skin of the face are a collection of cells in the upper dermis. They have a rounded, hemispherical or pointed shape, located in isolation and sharply delimited from the surrounding tissues. Papules that have just appeared are soft pink in color, they are shiny, with time they become copper in color or bluish-red. Even without treatment, papules resolve after 1 to 2 months. In their place remains brown pigmentation. In immunosuppressed patients, papules often erode (erosive papules) or turn into ulcers (ulcerative papules).

Rice. 23. Manifestations of syphilis of the secondary period - papular syphilis of the face and scalp.

Rice. 24. In the photo, the lesion of the lower eyelid in secondary syphilis is papular syphilis.

Seborrheic papules in secondary syphilis are located in places of increased sebum secretion - most often on the forehead. The surface of the papules is strewn with greasy scales.

Rice. 25. Seborrheic papular syphilis on the skin of the forehead.

Rice. 26. Syphilis on the face - seborrheic papular syphilis on the skin of the forehead, face and head.

Acneform (acne-like) syphilis

Acne syphilide is located in the mouths of the hair follicles. These are small rounded pustules with a conical apex, located on a dense base. When dried, a crust forms on their surface. After it falls off, a depressed scar remains. Acneform syphilide is most often located on the neck, scalp and upper body. Rashes in large numbers are recorded with fresh secondary syphilis, scanty rashes appear during subsequent relapses.

Rice. 27. Rash on the face with syphilis - acneiform syphilis.

Pustular syphilis

Papulopustular syphilides often appear in immunocompromised patients with severe concomitant diseases. Pustular (pustular) syphilides can be acne-like, impetiginous, pox-like, manifest as syphilitic ecthyma and rupee. In patients with low immunity, pustular syphilis resembles severe pyoderma.

Rice. 28. Syphilis on the face - papulo-pustular syphilis.

Herpetiform syphilis

Herpetiform (vesicular) syphilis is rare. It is usually registered in patients with severe disease and reduced immunity.

Rice. 29. Vesicular syphilis of the face.

Impetiginous syphilis

Impetiginous syphilide of the secondary period manifests itself in the form of a dark red papule, having the size of a pea or more. Further, the papule suppurates and becomes covered with a crust, from under which pus continues to stand out, upon drying of which a new crust appears. Layering can be large. After its rejection, the bottom of the syphilide is exposed. It is dark red in color, juicy, often with vegetative growths that resemble raspberries. When the ulcers merge, extensive areas of damage are formed (corrosive syphilide). Impetiginous syphilide of the scalp, nasolabial fold and beard growth area is similar to deep trichophytosis. On open areas of the face, rashes resemble impetiginous (superficial) pyoderma.