Syphilis physical examination: Difference between revisions

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File:800px-Primary stage syphilis sore (chancre) on the surface of a tongue-CDC.jpg| Primary stage syphilis sore (chancre) on the surface of a tongue.
File:800px-Primary stage syphilis sore (chancre) on the surface of a tongue-CDC.jpg| Primary stage syphilis sore (chancre) on the surface of a tongue. - By Centers for Disease Control and Prevention (CDC) - http://www.cdc.gov/std/syphilis/images.htm#, Public Domain, https://commons.wikimedia.org/w/index.php?curid=26062941


File:800px-Chancres on the penile shaft due to a primary syphilitic infection caused by Treponema pallidum 6803 lores.jpg|Chancres on the penile shaft due to a primary syphilitic infection
File:800px-Chancres on the penile shaft due to a primary syphilitic infection caused by Treponema pallidum 6803 lores.jpg|Chancres on the penile shaft due to a primary syphilitic infection - By CDC/M. Rein, VD - This media comes from the Centers for Disease Control and Prevention's Public Health Image Library (PHIL), with identification number #6803.Note: Not all PHIL images are public domain; be sure to check copyright status and credit authors and content providers.English | Slovenščina | +/−, Public Domain, https://commons.wikimedia.org/w/index.php?curid=743113
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Image:Secondary Syphilis on palms CDC 6809 lores rsh.jpg|Typical presentation of secondary syphilis rash on the palms of the hands and usually also seen on soles of feet
Image:Secondary Syphilis on palms CDC 6809 lores rsh.jpg|Typical presentation of secondary syphilis rash on the palms of the hands and usually also seen on soles of feet - By CDC/ Robert Sumpter - This media comes from the Centers for Disease Control and Prevention's Public Health Image Library (PHIL), with identification number #6809.Note: Not all PHIL images are public domain; be sure to check copyright status and credit authors and content providers.English | Slovenščina | +/−, Public Domain, https://commons.wikimedia.org/w/index.php?curid=2134272
Image:Vaginal syphilis (disturbing image).jpg|Secondary syphilis manifested perineal condylomata lata lesions  
Image:Vaginal syphilis (disturbing image).jpg|Secondary syphilis manifested perineal condylomata lata lesions - De Content Providers(s): CDC - This media comes from the Centers for Disease Control and Prevention's Public Health Image Library (PHIL), with identification number #4098.Note: Not all PHIL images are public domain; be sure to check copyright status and credit authors and content providers.English | Slovenščina | +/−The direct image URL is [1], Dominio público, https://commons.wikimedia.org/w/index.php?curid=21063
Image:Syphilis lesions on back.jpg|Syphilis lesions on a patient's back
Image:Syphilis lesions on back.jpg|Syphilis lesions on a patient's back - By Office of Medical History, US Surgeon General - Adapted from http://history.amedd.army.mil/booksdocs/wwii/internalmedicinevolIII/chapter20figure64.jpg, Public Domain, https://commons.wikimedia.org/w/index.php?curid=1202157
Image:Syphilis secondary 15.jpeg|Condymoata lata
Image:Syphilis secondary 15.jpeg|Condymoata lata - Adapted from Dermatology Atlas.<ref name="Dermatology Atlas">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/}}</ref>
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File:800px-Gumma of nose due to a long standing tertiary syphilitic Treponema pallidum infection 5330 lores.jpg|A gumma of nose due to a long standing tertiary syphilitic ''Treponema pallidum'' infection.
File:800px-Gumma of nose due to a long standing tertiary syphilitic Treponema pallidum infection 5330 lores.jpg|A gumma of nose due to a long standing tertiary syphilitic ''Treponema pallidum'' infection. - By CDC/ J. Pledger - This media comes from the Centers for Disease Control and Prevention's Public Health Image Library (PHIL), with identification number #5330.Note: Not all PHIL images are public domain; be sure to check copyright status and credit authors and content providers.English | Slovenščina | +/−, Public Domain, https://commons.wikimedia.org/w/index.php?curid=743277


Image:Syphilis tertiary 01.jpeg| Gummatous lesions in tertiary syphilis
Image:Syphilis tertiary 01.jpeg| Gummatous lesions in tertiary syphilis - Adapted from Dermatology Atlas.<ref name="Dermatology Atlas">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/}}</ref>
Image:Syphilis tertiary 02.jpeg| Gummatous lesions in tertiary syphilis
Image:Syphilis tertiary 02.jpeg| Gummatous lesions in tertiary syphilis - Adapted from Dermatology Atlas.<ref name="Dermatology Atlas">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/}}</ref>


Image:Syphilis tertiary 03.jpeg| Gummatous lesions in tertiary syphilis
Image:Syphilis tertiary 03.jpeg| Gummatous lesions in tertiary syphilis - Adapted from Dermatology Atlas.<ref name="Dermatology Atlas">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/}}</ref>
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Revision as of 15:31, 25 September 2017

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Aysha Anwar, M.B.B.S[2]; Nate Michalak, B.A.

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Overview

The physical examination findings of syphilis are described according to the stage of syphilis which includes non-tender chancre in primary syphilis followed by rash and generalized lymphadenopathy in secondary syphilis. Physical examination findings in tertiary syphilis depend on the organ system involved.[1][2][3]

Physical Examination

The physical examination findings of syphilis are described according to the stage of syphilis.[1][2][3]

Stage of syphilis Physical Examination Images
Primary syphilis

Chancre

Regional lymphadenopathy

  • Unilateral or bilateral
  • Lymph nodes are firm, painless, non-tender and non-suppurative
Secondary syphilis

Cardinal signs

  • Skin rash: initial macular lesions on the trunk and proximal limbs with progressive generalized papular rash and may cause necrotic ulcers

Condylomata lata

  • Reddish-brown papular lesions on the intertriginous areas that coalesce and enlarge into large plaques known as condylomata lata
  • Lesions usually progress from painful vesicular pattern to erosive lesions with resultant broad, grey-white highly infectious lesions

Superficial mucosal patches

Latent syphilis
  • Asymptomatic (serologically positive)
Tertiary syphilis

Neurosyphilis

  • Focal deficits
  • Intermittent or progresses slowly over a few days
  • Parenchymatous neurosyphilis

Cardiovascular syphilis

Gummatous lesions

  • Soft, asymmetric, coalscent granulomatous lesion
  • Solitary lesions less than a centimeter in diameter
  • Appear almost anywhere in the body
  • Cutaneous gumma: indurated, nodular, papulosquamous to ulcerative lesions with peripheral hyperpigmentation

References

  1. ↑ 1.0 1.1 Singh AE, Romanowski B (1999). "Syphilis: review with emphasis on clinical, epidemiologic, and some biologic features". Clin Microbiol Rev. 12 (2): 187–209. PMC 88914. PMID 10194456.
  2. ↑ 2.0 2.1 Carlson JA, Dabiri G, Cribier B, Sell S (2011). "The immunopathobiology of syphilis: the manifestations and course of syphilis are determined by the level of delayed-type hypersensitivity". Am J Dermatopathol. 33 (5): 433–60. doi:10.1097/DAD.0b013e3181e8b587. PMC 3690623. PMID 21694502.
  3. ↑ 3.0 3.1 Wöhrl S, Geusau A (2007). "Clinical update: syphilis in adults". Lancet. 369 (9577): 1912–4. doi:10.1016/S0140-6736(07)60895-2. PMID 17560432.
  4. ↑ 4.0 4.1 4.2 4.3 "Dermatology Atlas".
  5. ↑ Sapira JD (1981 Apr). ""Quincke, de Musset, Duroziez, and Hill: some aortic regurgitations"". South Med J. 74 (4): 459–67. Check date values in: |date= (help)


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