presented By
Name- RAHUL TALE
is a venereal (sexually-
transmitted)
•
Syphil
is
disease caused by spirochaetes,
Treponema
pallidum.
Mode of Transmission:
Syphilitic infection can be transmitted by the following routes:
1.Sexual intercourse is the most common route of
infection and results in lesions on glans penis, vulva,
vagina and cervix.
2.Intimate person-to-person contact with lesions on lips, tongue
or
fingers.
3.Transfusion of infected blood.
4.Materno-foetal transmission in congenital syphilis if the
mother is
infected.
Types:
SYPHILIS
ACQUIRE CONGENITAL
D
PRIMAR SECONDAR TERTIAR
Y Y Y
STAGE STAGE STAGE
ACQUIRED SYPHILIS:
• Acquired syphilis is caused due to Sexual
intercourse, Intimate person-to-person contact,
Transfusion of infected blood.
• Acquired syphilis is divided into 3 stages depending upon
the period after which the lesions appear and the type of
lesions.
• These are:
•
PRIMARY,
•
SECONDARY &
•
TERTIARY SYPHILIS
PRIMARY SYPHILIS
• After 2-4 weeks of infection, symptoms and
signs of primary syphilis develops.
• HALLMARK SIGN OF THIS STAGE: Development
of
CHANCRE.
– SEEN AT GENITAL OR EXTRA-GENITAL SITES
GENITAL –MALE & FEMALE
EXTRA-GENITAL SITES
CHANCRE:
• The chancre is the predominant lesion of primary syphilis.
• It appears about 3-4 weeks after infection and heals in
about 1–2 months in untreated individuals.
• In Men lesions occur on the
□ Penis, Anus, and Rectum
In Women lesions occur on the
□ Cervix, Vulva, and Perineum.
• Small lesions may also occur on the lips, tongue, buccal
mucosa,
and skin, and chancres of the eyelids and conjunctiva.
CHARACTERISTIC FEATURES OF CHANCRE:
• Lesion begins as an erythematous papule at the inoculation
site and later erodes to form a PAINLESS ULCER.
• The fully-developed chancre is an INDURATED
LESION WITH CENTRAL ULCERATION accompanied
by regional lymphadenitis.
• Classically lymph nodes are RUBBERY, PAINLESS, &
BILATERAL
• The chancre heals WITHOUT SCARRING, even in the
absence of treatment.
• Multiple chancres are seen in HIV patients infected with
syphilis.
• Antibody tests/serological tests are positive
after 1-3 weeks of appearance of chancres.
SECONDARY SYPHILIS
• Inadequately treated patients of
primary
syphilis develop
mucocutaneous lesions and painless
lymphadenopathy in 2-3 months after the
exposure
•Mucocutaneouslesions may bein the form of:
□
Mucous patches on mouth, pharynx and vagina; and
□
Generalised skin eruptions and
□
Condylomalata in anogenital region.
MUCOUS PATCHES
GENERALISED SKIN ERUPTIONS
CONDYLOMA LATA
• Secondary syphilis is highly infective stage
•Spirochaetes can be easily demonstrated
in the mucocutaneous lesions.
•Antibodytestsarealwayspositiveatthisstage
TERTIARY SYPHILIS
• After a latent period of appearance of
secondary lesions and about 2-3 years following
first exposure, tertiary lesions of syphilis
appear.
• Lesions of tertiary syphilis are much less
infective than the other two stages.
• Spirochaetes can be demonstrated with great
difficulty in the lesions .
Lesions are of 2 main types in Tertiary
syphilis: 1. SyphiliticGumma
2. Diffuselesionsoftertiarysyphilis
1. SYPHILITIC GUMMA:
• It is a solitary, localised, rubbery lesion with
central
necrosis, seen in organs like liver, testis, bone
and
• brain. It is a form of granuloma
• More commonly seen liver: HEPAR
LOBATUM/GUMMA HEPATIS.
GUMMA
FEATURES OF GUMMAS
• Gummas have a firm, necrotic (coagulative
center necrosis)
surrounded by inflamed tissue.
• Other histological features of gummas include:
□
an intervening zone containing Epithelioid
cells with indistinct borders & Multinucleated giant
cells,
□
□ can be seen
a peInrifpilhtreartailoznoonfelyomf
in
fpibhroocbyltaesstsananddpclaas
pmillaacrieelsls. the peripheral
zone as well.
2. DIFFUSE LESIONS OF TERTIARY SYPHILIS:
• The lesions appear following widespread dissemination of
spirochaetes in the body.
• The diffuse lesions are predominantly seen in cardiovascular and nervous
systems.
a.
Cardiovascular
syphilis: -
aortic
-anIenucroymsmp,etence of aortic valve
b.
Neurosyphilis:
- Meningovascularsyphilis
-T”abesdorsalisaffecting the spinal cord; and
-G”eneral paresis affecting the brain.
Aortic aneurysm
CONGENITAL SYPHILIS
• )
i)
ii)
iii
)
iv
Co foetus of more than 16 weeks gestation who is exposed
ng to maternal spirochaetaemia.
eni The major morphologic features as under:
tal
Saddle-shaped nose deformity due to destruction of
syp bridge of the nose.
hili
The characteristic ‘Hutchinson’s teeth’ which are small,
s
widely spaced, peg-shaped permanent teeth.
ma
Mucocutaneous lesions of acquired secondary
y
syphilis Bony lesions like epiphysitis and
de
vel periostitis.
op
in
a
v) Interstitial keratitis with
corneal opacity. vi) Diffuse
fibrosis in the liver.
vii) Interstitial fibrosis of lungs.
Hutchinson’s teeth Saddle-shaped nose
t h ank
you
