Congenital syphilis physical examination

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

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Physical Examination

Skin

• Early rash - small blisters on the palms and soles
• Later rash - copper-colored, flat or bumpy rash on the face, palms, and soles

Head

• Frontal bossing
• Poorly developed maxillae

Eyes

• Corneal clouding
• Interstitial keratitis (IK), an inflamation of the cornea which can lead to corneal scarring and potentially blindness
• Anemia
• Jaundice

Ears

• Deafness

Nose

• Snuffles, the name given to rhinitis in this situation. When chronic, this can lead to saddle nose deformity.
• Rhagades, linear scars at the angles of the mouth and nose result from bacterial infection of skin lesions

Throat

Shown below is an image of Hutchinson's teeth

• Hutchinson's Triad, a set of symptoms consisting of deafness, Hutchinson's teeth (centrally notched, widely-spaced peg-shaped upper central incisors), and interstitial keratitis (IK), an inflamation of the cornea which can lead to corneal scarring and potentially blindness
• Mulberry molars (sixth year molars with multiple poorly developed cusps)

Abdomen

• Enlarged liver
• Enlarged spleen

Extremities

• Sabre shins: Saber shin is a sharp-edged anteriorly convex tibia.
• Lymph node enlargement
• pseudoparalysis