Clinical manifestation

Primary syphilis: occurs within 3 weeks of contact with an infected individual; single ulcerated lesion with a surrounding red areola; ulcer edge and base have button-like consistency; usually heals within 4-8 weeks; painless regional lymphadenopathy Secondary syphilis: bilaterally symmetrical, pale red to pink, discrete, round mac-

554 Syringadenoma papilliferum ules on trunk and proximal extremities; after several days or weeks, appearance of red, scaly papules sometimes becoming necrotic; distributed widely, with frequent involvement of the palms and soles; small papular follicular syphilids involving hair follicles sometimes result in patchy alopecia; highly infectious papules develop at mucocutaneous junctions and in moist intertriginous skin, become hypertrophic and dull pink or gray (condyloma lata); superficial mucosal erosions on the palate, pharynx, larynx, glans penis, vulva, in anal canal and rectum (mucous patches) Late syphilis: usually solitary gummas presenting as indurated, nodular, papulosqua-mous or ulcerative lesions forming circles or arcs with peripheral hyperpigmentation; cardiovascular findings: diastolic murmur, secondary to aortic dilation with valvular insufficiency; symptomatic neurosyphilis, including meningovascular syphilis: cranial nerve palsies and pupillary abnormalities occurring with basilar meningitis (Argyll Robertson pupil); tabes dorsalis; ulcers of feet from loss of pain sensation Congenital syphilis:

Early manifestations: diffuse eruption, characterized by extensive sloughing of the epithelium, particularly on palms, soles, and skin around mouth and anus; abnormal bone radiographs; hepatomegaly; splenomegaly; petechiae; anemia lymphad-enopathy; jaundice; pseudoparalysis; snuffles; depressed linear scars radiating from the orifice of the mouth (rhagades or Parrot lines)

Late manifestations: interstitial keratitis; cranial nerve VIII deafness; corneal opacities; recurrent arthropathy Congenital neurosyphilis: gummatous periostitis, saddle nose, dental abnormalities including centrally notched and widely spaced, peg-shaped, upper central incisors (Hutchinson teeth) and sixth-year molars with multiple poorly developed cusps (mulberry molars); bone findings: frontal bossing, unilateral irregular enlargement of the sternoclavicular portion of the clavicle

How To Reduce Acne Scarring

How To Reduce Acne Scarring

Acne is a name that is famous in its own right, but for all of the wrong reasons. Most teenagers know, and dread, the very word, as it so prevalently wrecks havoc on their faces throughout their adolescent years.

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