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 symptomatology of the disease is diverse, 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 description 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 dense consistency. At first, the papules have a smooth surface, over time they begin to peel off, formed along the edge of the border, which is called the collar of Beetta. The rash appears in various places, but most often it is localized in the genital area, on the palms and soles. Papular syphilis of the palms and soles is characterized by the presence of hyperkeratosis.
The disease proceeds undulating. In this case, a person does not have itching and pain. Papules have a red or crimson color, they can spontaneously disappear without leaving scars.
With secondary syphilis, papules are scattered throughout the body randomly, and papular syphilis in the mouth and in the genital area are also located. In the oral cavity, papules are localized on the tonsils and tongue in the form of erosions and abrasions. In the area of the folds, they often get wet and deformed, condylomas may appear in their place.
Papular syphilis is quite contagious, as it contains a large number of pale treponemas.
Causes of the disease
The causative agent of syphilis is pale treponema. Infection occurs when it enters the body through the skin or mucous epithelium, the integrity of which is impaired. This can occur during sexual intercourse or through a contact-domestic way. Often, secondary syphilis is detected during a random examination or at a time when a person has a lesion of the tonsils.
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 pink borders with a purple hue, in their appearance and structure resembling lentils. On their surface there is an accumulation of dense scales, which are difficult to remove.
- Ring-shaped papules. In this case, the elements of the rash are grouped into rings or arcs.
- Horny papules are characterized by the presence of horny layers that resemble corns or warty growths.
- Keratodermia punctatum syphiliticum - papules of white color up to one centimeter in size, which rise above the surface of the skin and resemble in appearance millet grain, placed in a recess in the skin.
- A wide type is characterized by the presence of papules of different sizes, irregular shapes, which are covered with horny layers.
All of the above papular syphilis are painless, they do not itch and are not inflamed. Rashes are characterized by a chronic course.
What are the types of papular syphilis?
In medicine, several types of pathology are distinguished depending on the size of the 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. First, the rashes are red, and then they acquire a brown hue. At the places 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 papules the size of a millet kernel of copper color and a conical 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 conical in shape. In this case, the rash is compared with the so-called goose skin. Some doctors associate this disease with the presence of active tuberculosis in humans. Rashes are usually located on the body. This kind of disease is the most difficult to treat.
- Coin-shaped or nummular syphilis is characterized by the presence of papules, which have a coin size. Such rashes indicate a relapse of the disease. The number of papules is small, they can be observed anywhere on the body.
- Plaque papular syphilis is large compared to other varieties of papules. Typically, 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 oily scales on the face, forehead, scalp.
- Psoriasis-like, which strongly flaky and localized symmetrically under the armpits, in the popliteal fossae, folds of the elbows and scalp.
- Erosive syphilis acts as a weeping form of rashes formed on the mucous membrane of the epithelium and in the skin folds. This type of pathology is considered to be the most infectious.
Characteristics of rashes
Papular syphilis has some characteristics:
- First, there is a symmetrical, plentiful rash, the elements of which are small in size and brightly colored.
- Further, the number of papules decreases, they can group 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, rashes can be single. This suggests that the disease goes 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 course of pathology;
- spontaneous disappearance;
- great contagion.
Pathology during pregnancy
The disease is a danger to a pregnant woman and her unborn baby. According to statistics, in the absence of effective treatment, as well as when the pathology is not completely cured, the child will certainly become infected with secondary syphilis from an infected mother during labor.
Also, often women do not bear a child with such a disease. But when a woman is completely cured of secondary syphilis, she will undergo a course of effective therapy, will be constantly monitored by the attending physician, she will have a healthy child who will not have pathologies.
Symptoms and signs
Typically, with secondary syphilis, often spotted and papular syphilis often develop simultaneously. If in the second case the papules are peeling, then the first form of pathology is characterized by the appearance of pink spots without peeling.
The location of papules affects the manifestation of the symptoms of the disease. Horny papules are usually located on the limbs, in their appearance resemble corns. They can appear on the toes and between the toes. On those integuments that are equipped with a large number of sebaceous glands, in particular on the face, the papules are covered with yellow flakes, which resembles seborrhea. They can form into rings and arcs. Typically, such rashes are observed with a relapse of the pathology.
Papular syphilis on moist surfaces, for example, in the anus or genital area, often transform into erosion. In this case, the causative agent of infection comes to the surface of the skin. With friction or mechanical irritation, such papules lead to papillary growths.
Mucous membranes
Pathology also affects the mucous epithelium, erosions and even ulcers form on it. A yellow coating appears on their surface. Constant irritation of the papules leads to their growth, they can merge, forming a continuous infiltrate. Typically, this phenomenon is observed in the tonsils. In this case, the causative agent of the infection 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 rashes will have the same appearance as on the skin, but their color will be white.
Often a person develops papular tonsillitis in combination with laryngitis. Roseola and papules are formed on the mucosa of the epithelium of the epiglottis, vocal cords, which leads to hoarseness and aphonia.
When papules appear in the corners of the oral cavity and between the fingers, cracks form on their surfaces that cause pain.
Diagnostic measures
Papular syphilis, 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, upon examination, asks the patient to undress, and then examines his body, especially the genital area and the anus.
Then the doctor prescribes laboratory tests:
- Wasserman reaction.
- ELISA for the detection of STDs and secondary syphilis.
- Passive hemagglutination reaction in order to identify the stage of pathology.
- Examination in a dark field using a microscope to identify microorganisms.
- Precipitation reaction, as a result of which antibodies to pale treponem are detected.
- Immunofluorescence is performed to exclude false test results for syphilis.
Differential diagnosis
Papular syphilis is usually differentiated with diseases such as red and scaly lichen, parapsoriasis, skin vasculitis, skin tuberculosis, hemorrhoids, genital warts, rubella and measles, spotted taxidermy, as well as pigment urticaria, pemphigus, mock syphilitic papules.
Thus, differentiation is carried out with those diseases that manifest themselves in the form of a rash, multiple lesions of the skin and mucous membranes.
Therapy
Having studied what papular syphilis and their varieties are, you need to find out how the pathology is treated. Therapy in this case should be comprehensive and only under the supervision of a doctor. Usually antibacterial drugs are prescribed for a long period (at least twenty-four days). Penicillin antibiotics are used. Doctors say that secondary syphilis responds well to therapy, you only need to follow the doctor’s prescription and recommendations.
Medicines are used as injections, they are administered intramuscularly every three hours. The doctor also prescribes immunomodulators, biogenic stimulants, vitamin complexes and ultraviolet radiation. Skin rashes are treated with antiseptic solutions or iodine.
In modern clinics, they often use the “one-shot” treatment method. But this approach is not effective, in addition, it can lead to the opposite effect: the emergence of antibiotic resistance to the pathogen.
Forecast
Papular syphilis responds well to therapy, so effective treatment, if it is completely completed, gives positive predictions. Untimely treatment or premature termination of it provokes the transition of the disease to the next stage - tertiary syphilis.
Pathology Prevention
Preventive measures include:
- drug therapy;
- use of contraception;
- emergency 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 by a doctor.
For the purpose of prevention, it is necessary:
- have one sexual partner;
- do not have random sexual contacts;
- avoid contact with carriers of infection;
- use your own hygiene products
- periodically undergo testing for the presence of STDs.
When papular syphilis appears, 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. Such a pathology requires immediate therapy, which usually gives positive results. But only if the person will strictly comply with all the instructions of the attending physician.