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Clinical manifestations of the primary period of syphilis

Primary syphiloma is the first clinical manifestation of the disease that occurs at the site of the introduction of pale treponemas through the skin and mucous membranes (in the area of ​​the entrance gate). The appearance of an erosive or ulcerative defect is preceded by the appearance of a small hyperimic inflammatory spot, which after 2-3 days turns into a papule. Shortly after the appearance of the papule, the epidermis (epithelium) covering it undergoes decay, and erosion or ulcer is formed - actually the primary syphiloma.

Localization of primary syphilis in the area of ​​the entrance gate of infection. According to localization, primary syphilomas are divided into genital, perigenital, extragenital and bipolar.

Atypical primary syphilomas:

1. Inductive edema is persistent specific lymphangitis of the small lymphatic vessels of the skin, accompanied by the phenomena of lymphostasis.

2. Chancroid panaritium is localized on the distal phalanx of the finger and bears great resemblance to banal panaritium. It is characterized by the formation of an ulcer on the back surface of the terminal phalanx of the finger.

3. Chancre-amygdalitis is a specific one-sided enlargement and significant compaction of the tonsil without a defect on its surface. The tonsil has a stagnant red color, but is not accompanied by diffuse hyperemia.

The following complications of primary syphiloma are distinguished:

1) impetiginization. A hyperemic corolla appears on the periphery of syphiloma, the tissues acquire pronounced swelling, the brightness of the element increases, the discharge becomes abundant;

2) balanitis and balanoposthitis - in men, vulvitis and vulvovaginitis - in women;

3) phimosis.
Inflammatory phimosis is characterized by bright diffuse hyperemia, mild edema and an increase in the volume of the foreskin;

4) paraphimosis, which is an infringement of the glans penis by a narrowed foreskin ring, drawn to the coronal groove;

5) gangrenization. Oifiloma undergoes necrotic decay;

6) phagedenism, starting with the appearance of a necrosis site of a greater or lesser magnitude against the background of an ulcer. But the necrotic process spreads the limits of syphiloma.

Regional lymphadenitis. It is an enlargement of the lymph nodes draining the location of primary syphiloma.

Specific lymphangitis. It is an inflammation of the lymphatic vessel from a solid chancre to regional lymph nodes.

Specific polyadenitis. At the end of the primary period of syphilis in patients, specific polyadenitis occurs.

Prodromal syndrome. About 7–10 days before the end of the primary period and during the first 5–7 days of the secondary period, symptoms of a general nature are observed due to intoxication as a result of the massive presence of treponemas in the bloodstream. It includes fatigue, weakness, insomnia, decreased appetite and working capacity, headache, dizziness, improper type of fever, myalgia, leukocytosis, and anemia.
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Clinical manifestations of the primary period of syphilis

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