Syphilis is one of the most common and terrible diseases of the 20th century. For some time, the disease was the cause of death of a large number of people. Entire counties suffered from infection in Russia, and every fifth soldier in the army was infected. This is a classic sexually transmitted disease, which is mainly transmitted through sexual contact or in utero. But it is possible to get infected using personal hygiene items, from bites, during blood transfusion. The disease can occur in a latent form for decades, gradually moving from one stage to another, terrifying with its symptoms and external manifestations.
Causative agent of the disease
Hard chancre, inflammation of the lymphatic vessels, syphilitic roseola (spotted syphilis), papules, nodes and pustules are just some of the external manifestations of primary and secondary syphilis. But the true culprit in lesions of the skin, internal organs and systems is spirochete - pale treponema (Treponema pallidum). The microorganism was discovered only in 1905. It has an elongated body shape and fibrils, due to which it is capable of spiral movements. That is, the pathogen can move freely inside the host organism, invading intercellular compounds and affecting the internal organs, blood vessels and human tissues.
Secondary syphilis
The disease has three stages of the course. Primary syphilis is characterized by the gradual introduction of the pathogen into the body. At the site of treponema introduction, a hard chancre is formed - a painful ulcer. After 6-10 weeks after infection, a systemic lesion of the body occurs. All internal organs (including bones, nervous, lymphatic system, hearing and vision) are affected. It is during this period that a repulsive rash appears on the body, one of the varieties of which is syphilitic roseola. Photos of patients whose skin is covered with rashes look unpleasant. The rash occurs because the microbe is partially destroyed under the attack of cells of the immune system and releases endotoxin, a dangerous poison with angioparalytic properties. This symptom of syphilis is found in 80% of all cases in the secondary period.
The body usually manages to slightly weaken the pathogen, as a result of which the disease goes into a latent (latent) stage. The rash disappears for a while, so that it soon reappears. The reproduction of the microorganism is restrained, but a weakening of the immune system leads to relapse. This is because the immune system alone is not able to completely defeat the disease. In addition, the temperature of the human body is ideally comfortable for the life of the microbe. The secondary period can last from 2 to 4 years, flowing in waves and overgrowing with new clinical symptoms.
What skin diseases can be confused with?
Syphilitic roseola is similar to other pathologies of the skin, which are characterized by a pink rash:
- Toxic dermatitis as a reaction to medication, food, household chemicals. The difference between allergic spots is that they are prone to fusion, itch, merge with each other.
- Pink lichen appears as symmetrical round spots. This is a non-dangerous viral skin lesion that goes away on its own without treatment. In this case, there is always a mother plaque (with a diameter of up to 1 cm), which is detected first and has a larger size. The remaining elements appear gradually, their shape and size can be different and different from each other.
- Skin marbling can occur in response to hypothermia in completely healthy people. Expanded capillaries simply shine through the skin, giving it a marble tint. Syphilitic roseola after vigorous rubbing of the integument becomes even brighter, and the marble pattern, on the contrary, disappears.
- The spots of pityriasis (multi-colored) lichen also have a pink color, but sometimes they get a shade of coffee with milk. They are located on the back, chest and more often on the upper half of the body. They originate from the mouths of the hair follicles, peel strongly, in contrast to the manifestations of syphilis.
- The presence of pubic lice is indicated by bite marks. In the center of the spots of gray-violet color you can always notice a small dot. Traces do not disappear if pressed.
- With rubella, a rash is found not only on the body, but also on the face. It rises slightly above the covers, affects the pharynx and disappears on the third day. Body temperature rises, conjunctivitis occurs, lymph nodes increase.
- Measles is also characterized by a sharp increase in temperature, swelling of the eyelids, inflammation of the membranes of the upper respiratory tract, shortness of breath and conjunctivitis. The rash is large, prone to draining, white spots are noticeable on the mucous membranes of the mouth and gums.
- Typhus and typhoid fever occur with severe general intoxication of the body, fever and weakness. If you grease the stains with an alcoholic solution of iodine, then they acquire a darker shade.
Syphilitic roseola: differential diagnosis
Roseola, caused by syphilis, must be distinguished (differentiated) from other types of spotted rash, similar in appearance. And also from insect bites, allergies, infectious diseases (herpes, gonorrhea). The causes of the appearance of other rashes are completely different, as are the features of the manifestation, appearance, general symptoms and methods of treatment.
Using laboratory methods, you can determine that the rash is a syphilitic roseola. Dif Diagnosis is based on serological blood tests by detecting antigens and antibodies to the pathogen. One hundred percent result gives an analysis of the RIF. To do this, rabbit blood infected with the pathogen and a special serum are added to the patient’s blood taken for examination. When observed under a luminescent microscope, the presence of treponema in the body confirms the reflection - fluorescence. The absence of infection manifests itself in a yellowish-green glow.
An interesting fact: if 3 to 5 ml of nicotinic acid (0.5% solution) is administered intravenously to the patient, then the spots acquire a brighter shade. Also of great importance for the diagnosis is the presence of other symptoms of secondary syphilis. As well as the formation of solid chancre at the stage of primary syphilis.
Other symptoms of the disease
Stains of pink or red color of a round shape manifest syphilitic roseola. Symptoms of secondary syphilis also include:
- small focal or diffuse alopecia (occurs in 20% of patients and passes with the beginning of therapy);
- "Venus necklace" in the neck, rarely on the shoulders, limbs and lower back;
- papular syphilis;
- pustular syphilis;
- defeat of the vocal cords and a hoarse voice.
Symptoms of a rash
Syphilitic roseola, photos of which are presented in large quantities on the Internet, is characterized by certain signs:
- sizes of individual spots up to 1 cm;
- rashes have unclear contours;
- the surface of the spots is smooth, asymmetrical;
- rounded and asymmetrical outlines;
- there are no elements merged with each other;
- spots do not protrude above the skin;
- do not grow on the periphery;
- when pressed, slight lightening of the shade is possible, but not for long;
- no pain, peeling and itching.
For a long time, passing roseola can acquire a yellowish-brown tint. Rashes alone do not cause harm and are not dangerous. However, they are a signal to the body that it needs urgent help.
Syphilitic roseola: rash localization
Favorite spots are considered to be the limbs and lateral surfaces of the trunk (chest, abdomen). It can be on the bends of the limbs, affect the upper part of the legs. Roseola rarely occur on the feet, hands and face. The rash is disordered and profuse. It appears gradually, reaching the final development over 8–10 days. Syphilitic roseola variety has, depending on the appearance of the spots.
Types of syphilitic roseola
The following types of roseola exist:
- fresh (appears for the first time), the most abundant rash of bright color;
- urticaria, or edematous (similar to urticaria);
- ring-shaped syphilitic roseola is characterized by spots in the form of rings or half rings, arcs and garlands;
- with recurrent or confluent roseola, the size of the spots, as a rule, is much larger, and the color is more intense, but their number is smaller.
Very rarely, patients have a flaky roseola, covered with lamellar scales, and also similar to blisters, towering above the skin.
On the mucous membranes, erythematous syphilitic tonsillitis often develops . On the pharynx, confluent erythema is dark red, sometimes with a bluish tinge. Their contours sharply border healthy mucosal integuments. The patient does not feel pain, he is not in a fever, and the general condition is practically not broken.
Treatment
If you suspect a syphilitic nature of the rash, it is important to consult a doctor as soon as possible. Diagnosis is a dermatologist or venereologist.
The rash disappears spontaneously after a few days (sometimes months), gradually changing color. Subsequently, no trace on the skin remains. It is not necessary to treat rashes, but their causes. Fortunately, the causative agent of syphilis is a rare microorganism that has not yet developed antibiotic resistance. Syphilitic roseola, the treatment of which is carried out using conventional penicillin (sodium salt), is prone to exacerbation. After the introduction of the first intramuscular injection, the rash acquires a rich red tint. The patient may have a fever. Moreover, spots are formed on those parts of the body where previously they were not. As part of complex therapy, like decades ago, intravenous infusions of arsenic compounds are used (Novarsenol, Miarsenol). Solutions of iodide salts and other auxiliary preparations are also used. Treatment necessarily takes place in stationary conditions, which allows you to constantly monitor the patient’s health.
Therapy Features
Treatment should be carried out in courses, alternating with interruptions and be lengthy. The treatment regimen is selected individually taking into account the clinical characteristics of the disease. To eliminate the rash, lubrication with mercury ointment, washing with saline solutions, as well as thorough hygienic skin care are prescribed.
Prognosis for recovery
Syphilis is successfully treated in healthy and young people with a strong body. In children and the elderly it is always difficult to predict a positive result. The patient’s condition can be aggravated if he has serious heart damage, diabetes, kidney disease, liver disease, a history of rickets. In addition, the patient should stop drinking alcohol and limit smoking during treatment.
Consequences of infection
It is important to understand that syphilitic roseola is a rash that appears when the disease is already becoming serious. If treatment is not started at this stage, it will lead to irreparable consequences, irreversible disorders of the brain and spinal cord, circulatory system and other internal organs. Syphilis will smoothly and imperceptibly go into the third stage, which is absolutely not amenable to therapy. With tertiary syphilis, which develops in 40% of patients, it is only possible to maintain vital functions of the body and stabilize the condition. Like many sexually transmitted diseases, syphilis often results in disability or death.
Prevention
Syphilis is a serious disease that can be treated only in the early stages. Systemic lesions, when therapy is becoming more ineffective every day, is indicated by a rash - syphilitic roseola. The description of preventive measures is standard for all types of sexually transmitted infections. First of all, you should avoid promiscuous sexual intercourse, random sexual intercourse. The barrier method of contraception is still the main precautionary method. Using condoms, a person not only protects himself from infection, but also protects against possible infection of the sexual partner. After all, not every person is 100% sure that he is completely healthy, given the fact that some diseases have a long incubation period without any symptoms.