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Tertiary period of syphilis. Clinical manifestations

Lumpy syphilis. Typical places of its localization are the extensor surface of the upper limbs, trunk, face. The lesion focus occupies a small area of ​​the skin, is located asymmetrically.

The main morphological element of tubercular syphilide is a tubercle (dense, hemispherical, cavityless formation of a rounded shape, dense-elastic consistency).

Grouped tuberous syphilide is the most common species. The number of tubercles usually does not exceed 30–40. The tubercles are at different stages of evolution.

Serpentine tubercular syphilide. At the same time, individual elements merge into a dark red horseshoe-shaped roller raised above the level of the surrounding skin from 2 mm to 1 cm wide, on the edge of which fresh tubercles appear.

Tuberous syphilis site. Individual tubercles are not visible, they merge into plaques 5–10 cm in size, bizarre outlines sharply delimited from the unaffected skin and towering above it.

The plaque has a dense texture, brownish or dark crimson.

Dwarf tubercular syphilis. It is rarely observed. It has a small value of 1-2 mm. The tubercles are located on the skin in separate groups and resemble lenticular papules.

Gummous syphilis, or subcutaneous gum. This is a node that develops in the hypodermis. Characteristic places of localization of gum are shins, head, forearms, sternum.
The following clinical varieties of gummy syphid are distinguished: isolated gum, diffuse gummous infiltration, fibrous gum.

Isolated gum. Appears in the form of a painless knot 5–10 mm in size, spherical in shape, with a dense-elastic consistency, not soldered to the skin.

Gummous infiltration. Gummous infiltrate disintegrates, ulcerations merge, forming an extensive ulcerous surface with irregular large-pied contours, healing with a scar.

Fibrous gum, or periarticular nodularity, are formed as a result of fibrous degeneration of syphilitic gum.

Late neurosyphilis. It is mainly an ectodermal process relating to the nervous parenchyma of the brain and spinal cord. It usually develops after 5 years or more from the moment of infection. In late forms of neurosyphilis, degenerative-dystrophic processes predominate.

Late visceral syphilis. In the tertiary period of syphilis, limited gums or diffuse gummous infiltrations can occur in any internal organ.

The defeat of the musculoskeletal system. In the tertiary period, the musculoskeletal system may be involved in the process.

The main forms of bone damage in syphilis.

1. Gummous osteoperiostitis:

2. Gummous osteomyelitis:

3. Nonhummous osteoperiostitis.
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Tertiary period of syphilis. Clinical manifestations

  1. 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 covering it
  2. The course of the secondary and tertiary periods of syphilis. Malignant course of syphilis
    Secondary period. This period begins with the onset of the first generalized rashes (on average 2.5 months after infection) and lasts in most cases for 2–4 years. The duration of the secondary period is individual and is determined by the characteristics of the patient's immune system. In the secondary period, the most pronounced wave-like course of syphilis, i.e., alternation
  4. Tertiary syphilis
    tubercular syphus develops in approximately 40% of patients at the 3-4th year of the disease, lasts indefinitely and is manifested by the development of a specific inflammation - an infectious granuloma. Manifestations of the tertiary period are accompanied by the most pronounced, often indelible disfigurement of the patient’s appearance, severe violations in different organs and systems, lead to disability, and often
  5. Tertiary syphilis.
    It appears after the last relapse of secondary syphilis, in particular secondary recurrent syphilis, after a certain period of time, usually after 3-5 years (cases of earlier manifestations of 2-3 years, and later 10-15 years and even 30-40 years are described ) Manifestations of tertiary syphilis, in contrast to syphilis of the primary and secondary periods, are characterized by a more significant depth of damage
  6. tertiary syphilis
    It develops approximately 3-5 years after infection. It occurs: - in 64% of cases in those who have not been treated for early forms of syphilis; - in 35% - in poorly treated for early forms of syphilis; - in 1% of cases - in persons who have received full treatment. Thus, Lues III is not the inevitable end of the disease, despite the fact that the patient did not receive full treatment or
  7. Tertiary syphilis
    Lesions of the oral mucosa during tertiary syphilis can manifest as tubercles, gum and diffuse gummous infiltration. Tertiary syphilis are more common in the nose, soft and hard palate, palatine curtain; less often - in the tongue, behind the pharyngeal wall and lips. Localization of lesions significantly affects the clinical picture. Common clinical signs
  8. Tertiary syphilis. Congenital syphilis.
    Tertiary syphilis. Congenital
  9. Tertiary period
    In the tertiary period of syphilis (late syphilis, syphilis tertiaria, seu gummosa), all signs of severe chronic systemic infectious disease are clearly detected, in which changes develop in the affected organs that violate their normal function. Data on the frequency and timing of occurrence of tertiary syphilis are very contradictory. Results of 1404 untreated patients
  10. Bone damage in tertiary syphilis
    Forms of bone lesions in syphilis: periostitis, osteitis and osteomyelitis. They are limited or diffuse, widespread. Periostitis in the form of only bone changes is rare; they are combined with osteitis in those rare cases when only the periosteum is affected, the process occurs simultaneously in many bones and is characterized by the duration of existence. Distributed periostitis
  11. Tertiary syphilis
  12. Tertiary, Visceral, Hidden Syphilis
    Currently, there is a large group of sexually transmitted infections (STIs). Classification of STIs (WHO, 1982) Bacterial nature 1. Syphilis and other treponematoses (pint, frambesia, bezhel) 2. Gonorrhea 3. Chancroid 4. Venereal lymphogranulomatosis 5. Donovanosis 6. Urogenital chlamydia and Reiter’s disease 7. Urogenital mycoplasmosis (in t .h.
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